Workers Compensation Claims Examiner
- Career Level
- Not Specified
York Risk Services Group is a premier provider of insurance, risk management, alternative risk, pool administration and claims management solutions to clients across hundreds of industries. Recently named by Forbes as one of "America's Best Midsized Companies 2017" We firmly believe that our employees drive the success of the company. With success in mind as the ultimate goal, we strive to create and provide an environment that offers challenging, stimulating and financially rewarding opportunities.
*Must have New York State Adjusters License
Investigates claims to determine an injured workers entitlement to Workers Compensation benefits; Administers indemnity and medical benefits for valid Workers Compensation claims; Manages a caseload of claims from inception to closing or settlement.
- Completes 3-point contact on new claims within 24 hours in order to obtain information necessary to make a compensability decision on the claim
- Establishes appropriate reserve levels based on financial exposure and updates reserves upon receipt of new information
- Directs assistant to properly pay indemnity benefits and Awards. Issue state-mandated benefit notices within the required timeframes
- Annotates, categorizes and addresses incoming mail on a daily basis.
- Responding to questions and requests from the client.
- Ability to prioritize multiple tasks and meet deadlines
- Excellent written and verbal skills
- Excellent customer service skills
- Workers Compensation law, policies and procedures
- Medical and legal terminology
- Integration with Medicare
- BS / BA or Equivalent Work Experience
3 to 5 years