Claim Specialist

Responsibilities

• Investigate, evaluate, negotiate, and resolve lost time claims within settlement and reserving authority
• Communicate with insureds, injured workers, agents, brokers, witnesses, attorneys, and underwriters to determine coverage and liability
• Administer timely and accurate indemnity and medical benefits
• Work closely with defense counsel on litigated cases, including attending mediation, arbitration, and hearings
• Implement Managed Care strategies and coordinate rehabilitation or medical management
• Maintain quality claim files in accordance with company procedures and best practices
• Establish and maintain proper reserves and interact with State and Federal Boards and Commissions
• Mentor and train less experienced Claim Department representatives
• Maintain working knowledge of computer systems and stay updated on State laws

Requirements

• Mandatory New York claims experience
• 1-4 years of workers’ compensation lost time claim handling experience preferred
• Bachelor’s degree preferred
• Proficiency in Microsoft Word, Excel, and Image Right preferred
• Valid driver’s license
• Strong attention to detail and communication skills
• Ability to manage multiple priorities and work effectively in a team

Benefits

• Health, Dental, and Vision insurance options
• 401(k) retirement plan with up to 6% match plus annual bonus
• 5 weeks of Paid Time Off (PTO) and 11 paid holidays
• Paid Parental Leave
• Student loan paydown and refinancing assistance
• Educational assistance for job-related courses and certifications
• Flextime schedules and volunteer time off