Workers Compensation Claims Examiner – Dedicated Client

Workers Compensation Claims Examiner – Dedicated Client

Requirements

• Minimum of (2) years of workers’ compensation claims handling experience.
• Experience specifically with New York jurisdictional regulations, including knowledge of New York State Workers’ Compensation Board rules and procedures.
• Experience with Public Entity claims management.
• High school diploma or equivalent; a college degree or relevant certifications (e.g., WCCP, AIC) is a plus.
• Strong understanding of workers’ compensation claims processes, policies, and legal requirements in New York.
• Excellent written and verbal communication skills.
• Strong analytical skills with attention to detail and accuracy.
• Ability to manage multiple claims simultaneously and prioritize workload effectively.
• Proficiency with claims management software and Microsoft Office Suite (Excel, Word, Outlook).
• Ability to negotiate settlements and resolve claims disputes effectively.

Responsibilities

• Independently handle a capped caseload of workers’ compensation claims, from inception to resolution, ensuring adherence to company procedures, industry best practices, and regulatory requirements.
• Ensure compliance with New York workers’ compensation laws, including timely filing of reports, adherence to benefit payment timelines, and compliance with statutory requirements.
• Negotiate settlements of claims within designated authority to reach claim resolution.
• Provide clear and effective communication with the claimant and client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
• Maintain accurate and comprehensive records in the claims management system, documenting all actions, decisions, and correspondence related to each claim.

Preferred Qualifications

• A college degree or relevant certifications (e.g., WCCP, AIC) is a plus.