Field Claims Adjuster in a hybrid role at ClaimsPro supporting claims in Prince Albert area. Actively adjusting claims and ensuring business development opportunities are maximized.
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.
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