Hybrid Workers Compensation Claims Examiner – NY Jurisdiction

Posted 2 weeks ago

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About the role

  • 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

Job type

Experience level

JuniorMid level

Salary

$85,000 - $95,000 per year

Degree requirement

High School Diploma

Location requirements

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