Claims Examiner
1 week ago
A professional services organization, Tandym Group, is seeking a skilled Claims Examiner to join their team.
Responsibilities:
- Review and determine the compensability of workers' compensation claims in the electrical industry.
- File necessary forms in a timely manner.
- Manage the medical aspects and investigations of claims.
- Calculate payroll and compensation based on established guidelines.
- Act as a liaison with relevant parties in the review process.
- Assign cases for investigation and monitor progress.
- Prepare claims for long-term disability.
- Evaluate the degree of disability and loss value.
- Maintain professional relationships with involved parties.
- Make appropriate case referrals as needed.
- Execute claims activities to ensure quality service.
- Develop action plans for claims resolution.
- Analyze and process workers' compensation claims.
- Communicate with union representatives regarding claims management.
- Perform additional duties as required.
Qualifications:
- Bachelor's degree required.
- Minimum 3 years experience as a workers' compensation examiner.
- Knowledge of NYS Disability and Worker's Compensation laws.
- Strong interpersonal, organizational, and communication skills.
- Proficiency in Microsoft Word & Excel.
- Ability to work independently and collaboratively.
- Familiarity with claim reserve and sound judgment.
- Strict confidentiality.
Work Environment:
- Operates in a professional office setting.
- Requires use of standard office equipment.
- Physical demands involve lifting, bending, and standing.
- Full-time position with flexibility for overtime.
- No travel required.
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