Loss Time Claims Adjuster
Job Description:
- Investigate and gather information to determine compensability through three-point contact interviews with the employer, claimant, and healthcare provider
- Secure and file necessary documents, including FROI and SROI forms with the NYS Workers’ Compensation Board, claimant, and claimant’s attorney
- Establish reserves and authorize payments and treatment within NYS Medical Treatment Guidelines and assigned authority
- Examine and authorize payment of medical bills
- Recognize and refer cases when IMEs are indicated
- Prepare and instruct counsel to defend company interests at NYS Workers’ Compensation Board hearings
- Respond to written and telephone inquiries from claimants, clients, attorneys, doctors, and vendors
- Establish cost containment techniques, vendor referrals, recoveries, and strategic case planning
- Identify cases meeting criteria for reporting to the Excess Carrier
- Negotiate settlements
- Control the claim process from investigation through settlement
Requirements:
- New York State License is required or obtained within 6 months of employment
- Exceptional telephone demeanor
- Ability to maintain a high level of confidentiality
- Prior experience in adjusting New York State workers’ compensation claims
- Bachelor’s degree is preferred
- Volunteer Firefighters, 207(a) and 207(b) claims handling experience are preferred
Benefits:
- Medical/Rx insurance
- Dental insurance
- Vision insurance
- Life Insurance
- Disability Insurance
- ESPP
- 401k
- Student Loan Assistance
- Tuition Reimbursement
- Free Mental Health & Enhanced Advocacy Services
- Paid Time Off
- Holidays
- Preferred Partner Discounts