Workers' Compensation Claims Examiner managing and processing claims in New York jurisdiction. Ensuring compliance with laws and providing clear communication with claimants and clients.
Responsibilities
Independently handle a capped caseload of workers' compensation claims, from inception to resolution, ensuring adherence to company procedures, industry best practices, and regulatory requirements.
Ensure compliance with New York workers' compensation laws, including timely filing of reports, adherence to benefit payment timelines, and compliance with statutory requirements.
Negotiate settlements of claims within designated authority to reach claim resolution.
Provide clear and effective communication with the claimant and client.
Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
Maintain accurate and comprehensive records in the claims management system, documenting all actions, decisions, and correspondence related to each claim.
Requirements
Minimum of (2) years of workers' compensation claims handling experience.
Experience specifically with New York jurisdictional regulations, including knowledge of New York State Workers' Compensation Board rules and procedures.
Experience with Public Entity claims management.
High school diploma or equivalent; a college degree or relevant certifications (e.g., WCCP, AIC) is a plus.
Strong understanding of workers' compensation claims processes, policies, and legal requirements in New York.
Excellent written and verbal communication skills.
Strong analytical skills with attention to detail and accuracy.
Ability to manage multiple claims simultaneously and prioritize workload effectively.
Proficiency with claims management software and Microsoft Office Suite (Excel, Word, Outlook).
Ability to negotiate settlements and resolve claims disputes effectively.
Benefits
Flexible work schedule.
Capped Case Load.
In-depth training.
Sedgwick funded licensing.
Referral incentive program.
Opportunity to work in an agile or remote environment.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
Job title
Workers Compensation Claims Examiner – NY Jurisdiction
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