Claims Examiner – Workers Compensation

Role Overview

• Analyzes Workers Compensation claims on behalf of our valued clients to determine benefits due.
• Ensures ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Manages complex workers’ compensation claims from initial investigation through final resolution.
• Evaluates claim exposure and develops action plans to drive timely, effective outcomes.
• Negotiates settlements within authority while ensuring compliance with guidelines.
• Establishes and maintains accurate reserves throughout the life of each claim.
• Prepares and submits required state filings within statutory deadlines.
• Oversees litigation, partnering with vendors to manage strategy and control costs.
• Reports to excess carriers and responds to requests promptly and professionally.
• Communicates regularly with claimants and clients to provide updates and maintain strong relationships.

Requirements

• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• 5 years of claims management experience or equivalent combination of education and experience required.
• NY jurisdiction and NY licensing knowledge.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.