Job Description:
• Investigate and gather information to determine compensability through three-point contact interviews with the employer, claimant, and healthcare provider
• Secure and file necessary documents, including FROI and SROI forms with the NYS Workers’ Compensation Board, claimant, and claimant’s attorney
• Establish reserves and authorize payments and treatment within NYS Medical Treatment Guidelines and assigned authority
• Examine and authorize payment of medical bills
• Recognize and refer cases when IMEs are indicated
• Prepare and instruct counsel to defend company interests at NYS Workers’ Compensation Board hearings
• Respond to written and telephone inquiries from claimants, clients, attorneys, doctors, and vendors
• Establish cost containment techniques, vendor referrals, recoveries, and strategic case planning
• Identify cases meeting criteria for reporting to the Excess Carrier
• Negotiate settlements
• Control the claim process from investigation through settlement
Requirements:
• New York State License is required or obtained within 6 months of employment
• Exceptional telephone demeanor
• Ability to maintain a high level of confidentiality
• Prior experience in adjusting New York State workers’ compensation claims
• Bachelor’s degree is preferred
• Volunteer Firefighters, 207(a) and 207(b) claims handling experience are preferred
Benefits:
• Medical/Rx insurance
• Dental insurance
• Vision insurance
• Life Insurance
• Disability Insurance
• ESPP
• 401k
• Student Loan Assistance
• Tuition Reimbursement
• Free Mental Health & Enhanced Advocacy Services
• Paid Time Off
• Holidays
• Preferred Partner Discounts