Workers Comp Claims Associate
About The Position
JOB DESCRIPTION Review of industry workers compensation claims and determine compensability File all required workers compensation forms timely Oversee medical management and investigations of claims Calculate payroll and compensation payment based on set guidelines Serve as liaison and interface with Comp nurse and claimant as part of the review process Assign cases for investigations and review progress Prepare workers compensation claim for long-term disability Ability to evaluate the degree of disability and scheduled loss value Maintains professional relationship with all appropriate parties involved with the claim. Refers cases as appropriate to management. Actively executes appropriate claims activities to ensure consistent delivery of quality claims service. Develops and manages claims through well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution Analyzes and processes workers' compensation claims by investigating and gathering information to determine the exposure on the claim Communicate with company representative regarding claims management. Perform other duties and special assignments as necessary
Requirements
- A four-year college degree preferred.
- A minimum of 3 years of experience as workers' compensation examiner required
- Extensive knowledge of NYS Disability and Worker's Compensation laws
- Excellent interpersonal, organizational, and communication skills
- Working knowledge of Microsoft Word & Excel
- Must be able to work independently and collectively
- Familiarity with claim reserve
- Must possess the ability to make sound judgment
- Strict confidentiality
- This is a full-time onsite 35 hours per week position.
- Days and hours of work are Monday through Friday 8:30AM-4:30PM
Responsibilities
- Review of industry workers compensation claims and determine compensability
- File all required workers compensation forms timely
- Oversee medical management and investigations of claims
- Calculate payroll and compensation payment based on set guidelines
- Serve as liaison and interface with Comp nurse and claimant as part of the review process
- Assign cases for investigations and review progress
- Prepare workers compensation claim for long-term disability
- Ability to evaluate the degree of disability and scheduled loss value
- Maintains professional relationship with all appropriate parties involved with the claim.
- Refers cases as appropriate to management.
- Actively executes appropriate claims activities to ensure consistent delivery of quality claims service.
- Develops and manages claims through well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution
- Analyzes and processes workers' compensation claims by investigating and gathering information to determine the exposure on the claim
- Communicate with company representative regarding claims management.
- Perform other duties and special assignments as necessary
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
