Workers Compensation Claim Consultant

Ccmsi • Wall Township, NJ

304d • $80,000 - $85,000 • Remote

About The Position

The Workers' Compensation Claim Consultant is responsible for overseeing a multiple-account desk within the New York jurisdiction while also managing select claims from New Jersey. This position requires an in-depth understanding of New York Workers' Compensation laws and regulations, ensuring timely and effective claims management. The role demands a proactive approach to claims handling, with an emphasis on high-quality service, effective litigation management, and compliance with corporate and client standards. This position also offers opportunities for professional growth and career advancement.

Requirements

• 5+ years of experience handling New York Workers' Compensation claims.
• Deep knowledge of New York Workers' Compensation laws.
• New York Adjuster's License (required).
• Strong organizational skills with the ability to prioritize multiple tasks effectively.
• Proficiency in Microsoft Office (Word, Excel, Outlook).
• Excellent written and verbal communication skills.

Nice To Haves

• Experience managing claims across multiple jurisdictions.

Responsibilities

• Investigate, evaluate, and adjust workers' compensation claims in compliance with NY and NJ laws, as well as client-specific guidelines.
• Establish and recommend reserves within established authority levels.
• Analyze medical, legal, and damage invoices for reasonableness and negotiate disputed bills as necessary.
• Authorize and process payments in accordance with industry standards and settlement authority.
• Negotiate settlements with claimants and attorneys, ensuring compliance with state laws and client authorizations.
• Partner with defense attorneys and manage relationships with external vendors for legal, surveillance, and case management services.
• Prepare detailed reports on claim statuses, payments, and reserves, and provide updates for excess insurers.
• Deliver exceptional claim services to CCMSI clients, adhering to our corporate standards.
• Represent CCMSI at hearings, mediations, and legal conferences as needed.

Benefits

• 4 weeks of PTO in your first year + 10 paid holidays.
• Medical, Dental, Vision, Life Insurance, Critical Illness, Short & Long-Term Disability.
• 401K and Employee Stock Ownership Plan (ESOP).

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities