Claims Adjuster - Workers Compensation (Medical) - Uniondale, NY

Brown & Brown, Inc  |  Uniondale, NY  |  Claims, Workers' Compensation, Accounting
 
 

Wright Specialty Ins. Agency, LLC is currently seeking a claims adjuster to join its team in Uniondale, NY, to manage and process workers' compensation medial claims with high exposure and complexity within specific limits and authority.

 

Responsibilities:

  • Investigate and gather information to determine compensability by conducting two point contact interviews with the employer and healthcare provider  
  • Secure and file necessary documents including FROI forms with the NYS Workers’ Compensation Board, claimant and claimant’s attorney
  • Establish medical reserves, authorize payments & treatment within the NYS Medical Treatment Guidelines, under set authority
  • Examine and authorize payment of medical bills
  • Recognize when IME’s are indicated and refer file to appropriate vendor
  • Respond to written and telephone inquiries from claimants, clients, attorneys, doctors & vendors
  • Establish proper cost containment techniques
  • Recognize cases that meet the criteria for transfer of the case to a Lost Time Adjuster, including referral of case to Team Leader
  • Control the disposition of the claim process & close files upon completion of all file tasks

 Requirements:

  • Prior experience in adjusting New York State workers’ compensation claims 
  • New York State License is required or obtained within 6 months of employment

 

Preferred: 

  • Associates degree 

 

 

We are an Equal Opportunity Employer. 
We take pride in the diversity of our team and seek diversity in our applicants.