Claims Adjuster II

Amynta Agency•Syracuse, NY

About The Position

We’re thrilled that you are interested in joining us here at the Amynta Group! As a member of Oryx Insurance Brokerage, Inc claims team, utilize knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex construction nature in order to achieve appropriate outcomes. In this position you will administer and resolve Workers Compensation claims in a timely manner in accordance with legal statues, policy provisions and carrier guidelines.

Requirements

Claims Adjusters License required
Bachelor's degree, or four or more years of equivalent work experience.
At least 3 or more years’ experience handling New York State lost time workers compensation construction claims
Familiarity with medical terminology.
Strong organizational skills and ability to manage multiple tasks simultaneously.
Demonstrated ability to work independently and with a team.
Ability to analyze data and make sound decisions.
Strong verbal and written communication skills.
Strong Knowledge of OSHA construction standards
Knowledge of NYS labor Law §240
Computer literacy, including working knowledge of MS Office products including Word, Excel and PowerPoint.
Ability to travel for business purposes, less than 15%.

Nice To Haves

Associate in Claims (AIC) Designation or similar professional designation desired.
Knowledge of Claim Center a plus.

Responsibilities

Promptly investigate all assigned claims with minimal supervision, including those of a more complex Construction nature.
Determine coverage, compensability, potential for subrogation recovery, and other offsets (when applicable).
Alert Supervisor and carriers Special Investigations Unit to potentially suspect claims.
Ensure timely denial or payment of benefits in accordance with jurisdictional requirements.
Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure.
Negotiate claims settlements with carriers approval.
Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition.
Work collaboratively with medical professionals to develop and execute return to work strategies.
Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome.
Maintain a working knowledge of New York State requirements and applicable case law for NY.
Demonstrate technical proficiency through timely, consistent execution of best claim practices.
Communicate effectively, verbally and in writing, with internal and external parties on a wide variety of claims and account issues.
Provide a high degree of customer service to clients, including but not limited to day to day interactions, claims reviews and renewal meetings.
Authorize medical treatment based on protocols established by NYS WC law
Assist Underwriting on new and renewal business