New York Workers Compensation Claims Adjuster
About The Position
A well-established third-party administrator (TPA) is seeking an experienced Senior Workers’ Compensation Claims Adjuster to support a dedicated account. The role is described as fully remote and involves independently managing a complex workers’ compensation caseload from claim inception through resolution while providing excellent service to the client and injured workers. The posting contains jurisdiction inconsistencies: the title and requirements specify New York, while the overview refers to Vermont and the responsibilities mention New England workers’ compensation laws. The role offers an annual salary of $80,000–$95,000, annual bonus potential, a comprehensive benefits package, the opportunity to support a stable, long-term dedicated account, and a collaborative and supportive claims leadership team.
Requirements
- At least 5 years of workers’ compensation claims adjusting experience within the New York jurisdictions.
- Strong understanding of New York workers’ compensation regulations and claims procedures.
- Experience handling complex and litigated claims.
- Strong organizational, analytical, and negotiation skills.
- Ability to independently manage a full caseload in a remote work environment.
- Active Connecticut adjuster license or ability to obtain one quickly.
Nice To Haves
- Prior experience working for a TPA or insurance carrier.
Responsibilities
- Manage a full caseload of New York workers’ compensation claims from inception to closure.
- Investigate claims to determine compensability and appropriate reserves.
- Handle claims in compliance with applicable workers’ compensation laws and regulatory requirements.
- Coordinate and communicate with injured workers, employers, medical providers, attorneys, and other stakeholders.
- Establish and adjust reserves based on claim developments and exposure.
- Direct medical management, including coordinating with nurse case managers when appropriate.
- Evaluate claims for settlement opportunities and participate in negotiations when necessary.
- Manage litigated claims in coordination with defense counsel to develop strategies and control costs.
- Maintain accurate claim documentation and provide timely claim updates to the client.
- Deliver high levels of customer service to a dedicated client account while meeting service standards and KPIs.
Benefits
- Annual bonus potential.
- Comprehensive benefits package.
- Opportunity to support a stable, long-term dedicated account.
- Collaborative and supportive claims leadership team.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
