Workers Compensation Claims Examiner | NY Jurisdiction & Subrogation Experience & NY Licensing Required

Sedgwick•Syracuse, NY

6d•$80,000 - $90,000•Hybrid

About The Position

The Workers Compensation Claims Examiner analyzes lost-time workers compensation claims on behalf of clients to determine benefits due and ensure claims are adjudicated within service expectations, industry best practices, and client-specific requirements. The role requires New York jurisdiction knowledge and licensing, as well as subrogation experience. The position is hybrid for employees within commuting distance of the Syracuse, New York office and remote for those outside that commuting distance. The examiner investigates claims, develops action plans, determines claim exposure, and works toward appropriate and timely resolutions. The role also includes negotiating settlements within designated authority, communicating claim activity with claimants and clients, and reporting claims to excess carriers while responding professionally and promptly to requests for direction.

Requirements

Five years of claims management experience or an equivalent combination of education and experience.
High school diploma or GED.
New York jurisdiction knowledge.
New York licensing.
Subrogation experience.
Ability to think clearly and conceptually and exercise sound judgment, troubleshooting, problem-solving, analysis, and discretion.
Ability to handle work-related stress and multiple priorities simultaneously, and meet deadlines.
Computer keyboarding ability; hearing, vision, and talking abilities.

Nice To Haves

Bachelor's degree from an accredited college or university.
Professional certification applicable to the line of business.

Responsibilities

Analyze and process claims using well-developed action plans to reach appropriate and timely resolutions.
Investigate claims and gather information to determine claim exposure.
Negotiate claim settlements within designated authority.
Communicate claim activity and processing with claimants and clients.
Report claims to the excess carrier and respond to requests for direction professionally and promptly.
Adjudicate lost-time workers compensation claims to determine benefits due while meeting service expectations, industry best practices, and client-specific requirements.