Loss Time Claims Adjuster

This is a fully remote position, open to applicants in New York.

📋 Description

• Conduct investigations and collect information to assess compensability through three-point contact interviews with the employer, claimant, and healthcare provider.

• Obtain and submit required documents, including FROI and SROI forms to the NYS Workers’ Compensation Board, the claimant, and the claimant’s attorney.

• Set reserves and authorize payments and treatments in accordance with NYS Medical Treatment Guidelines and granted authority.

• Review and approve medical bill payments.

• Identify and refer cases that require Independent Medical Examinations (IMEs).

• Prepare and guide legal counsel to advocate for the company’s interests during hearings at the NYS Workers’ Compensation Board.

• Address written and telephone inquiries from claimants, clients, attorneys, doctors, and vendors.

• Implement cost containment strategies, vendor referrals, recoveries, and strategic case planning.

• Detect cases that qualify for reporting to the Excess Carrier.

• Negotiate settlements effectively.

• Oversee the claims process from the investigation stage through to settlement.

⛳️ Requirements

• A New York State License is required or must be obtained within 6 months of employment.

• Excellent telephone etiquette.

• Capability to uphold a high level of confidentiality.

• Previous experience in adjusting New York State workers’ compensation claims.

• A Bachelor’s degree is preferred.

• Experience handling Volunteer Firefighters, 207(a), and 207(b) claims is preferred.

🏝️ Benefits

• Medical/Rx insurance.

• Dental insurance.

• Vision insurance.

• Life Insurance.

• Disability Insurance.

• Employee Stock Purchase Plan (ESPP).

• 401k plan.

• Student Loan Assistance.

• Tuition Reimbursement.

• Complimentary Mental Health & Enhanced Advocacy Services.

• Paid Time Off.

• Holidays.

• Discounts through Preferred Partners.