Workers Comp Claims Associate

JOB DESCRIPTION

• Review of industry workers compensation claims and determine compensability
• File all required workers compensation forms timely
• Oversee medical management and investigations of claims
• Calculate payroll and compensation payment based on set guidelines
• Serve as liaison and interface with Comp nurse and claimant as part of the review process
• Assign cases for investigations and review progress
• Prepare workers compensation claim for long-term disability
• Ability to evaluate the degree of disability and scheduled loss value
• Maintains professional relationship with all appropriate parties involved with the claim.
• Refers cases as appropriate to management.
• Actively executes appropriate claims activities to ensure consistent delivery of quality claims service.
• Develops and manages claims through well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution
• Analyzes and processes workers’ compensation claims by investigating and gathering information to determine the exposure on the claim
• Communicate with company representative regarding claims management.
• Perform other duties and special assignments as necessary

Required Experience, Skills, and Qualifications

• A four-year college degree preferred.
• A minimum of 3 years of experience as workers’ compensation examiner required
• Extensive knowledge of NYS Disability and Worker’s Compensation laws
• Excellent interpersonal, organizational, and communication skills
• Working knowledge of Microsoft Word & Excel
• Must be able to work independently and collectively
• Familiarity with claim reserve
• Must possess the ability to make sound judgment
• Strict confidentiality

This is a full-time onsite 35 hours per week position. Days and hours of work are Monday through Friday 8:30AM-4:30PM