Claim Specialist I - IV (NY WC Claims)
New
M
MEMICInsurance
RemoteFull-TimeMiddle
Salary$65,000-$98,500 depending on experience
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Job Details
- Experience
- One to four years of workers’ compensation lost time claim handling experience preferred.
- Required Skills
- Microsoft ExcelNegotiation
Requirements
- Must have New York (NY) workers' compensation claims experience.
- One to four years of workers’ compensation lost time claim handling experience preferred.
- Bachelor’s degree preferred.
- Computer skills including proficiency in Microsoft Word and Excel.
- Experience with Image Right document management software preferred.
- Must possess a valid driver’s license.
- Strong verbal and written communication skills.
- Strong attention to detail and ability to manage multiple priorities.
- Adaptable, flexible, and self-directed work style.
- Ability to work effectively within a team environment.
- Ability to travel as required to handle assigned claims inventory.
Responsibilities
- Communicate with insureds, injured workers, agents, brokers, and legal counsel to determine coverage, facts of loss, and liability.
- Administer the delivery of timely, appropriate, and accurate indemnity and medical benefits.
- Evaluate claim exposure, negotiate settlements, and manage litigation plans with defense counsel.
- Maintain quality claim files in accordance with best practices and company procedures.
- Implement managed care strategies, coordinate medical management, and monitor rehabilitation progress.
- Interact with state and federal boards while establishing proper reserves.
- Educate injured workers and insureds on state laws and relevant claims procedures.
- Prepare and present files for agent, broker, and insured reviews.
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