Remote Position

Loss Time Claims Adjuster

🌍 Remote · United States 💼 Full-time

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
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