Workers' Compensation Claims Specialist

4 weeks ago


New Haven, Connecticut, United States Yale New Haven Health Full time
Job Summary

We are seeking a highly skilled Workers' Compensation Claims Specialist to join our team at Yale New Haven Health. The ideal candidate will have a strong working knowledge of Connecticut Workers' Compensation laws and be able to work independently with minimal supervision.

Key Responsibilities
  • Review new Workers' Compensation claims to ensure compensability and proper documentation of injury.
  • Negotiate with claimants, physicians, attorneys, and the Commissioner to determine the best course of action for efficient claims management or settlement.
  • Work with medical providers to gather medical information and authorize medical treatment or procedures.
  • Determine the most effective method and timing of ongoing follow-up to bring cases to closure and limit hospital exposure.
  • Identify potential recoveries from third parties and take appropriate action to initiate recoveries.
  • Monitor progress of all claims activity to ensure proper valuing and case management.
  • Calculate and verify Workers' Compensation indemnity payments and authorize medical payments.
  • Establish financial reserves with documented rationale and review and adjust reserves for the life of the claim.
  • Represent Yale New Haven Health at hearings before the State of Connecticut Compensation Commissioner.
Requirements
  • Bachelor's degree or equivalent work experience.
  • Three to five years of experience in handling Workers' Compensation claims.
  • Current Connecticut Licensed Claims Adjustor required.
  • Strong Microsoft Office skills, especially Excel, and excellent typing and data entry skills.
  • Ability to make arithmetic calculations and work frequently with figures.
  • Good oral and written communication and interpersonal skills.


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