Claims Examiner #ESF1936

• Great work-life balance!
• Market leader in commercial insurance and risk management!
• Offer a wide range of career paths and opportunities for growth!
• Competitive Compensation and Benefits: health insurance, retirement plans, and other benefits!

What you will be doing:

• Investigate and manage workers' compensation claims in multiple jurisdictions.
• Handle medical and litigation management to drive claims to closure.
• Coordinate with nurse case managers, counsel, external vendors, and insureds for efficient claims handling.
• Complete and document initial loss investigations to determine compensability.
• Establish initial and subsequent reserves to ensure adequacy for anticipated exposure.
• Review medical bills for causal relationship to reported claims.
• Liaise with insureds, nurse case managers, and counsel to manage claims and facilitate returns to work.
• Develop and maintain action plans to ensure reserve adequacy and timely resolution of claims.
• Negotiate settlement of claims within designated authority.
• Prepare and present claim review summaries for insureds, brokers, and internal contacts as requested.
• Participate in roundtable discussions with insureds and counsel on strategies for successful claim closure/resolutions.
• Provide guidance and assistance to insureds and brokers on timely reporting of claims.
• Manage insured onboarding, including training on claims reporting and the use of the insured portal.

Experience you will need:

• Bachelor’s degree preferred.
• Professional designation such as CPCU, ARM, CRM, or similar preferred.
• Proficient in Microsoft Office with an aptitude to learn other software applications.
• Excellent oral and written communication skills.
• Detail-oriented with a high accuracy rate.
• Strong critical thinking and organizational skills.
• Ability to problem solve and use good judgment.
• Self-motivated with excellent time management skills.
• 5+ years adjusting workers' compensation claims in multiple jurisdictions.
• Experience in NY, NJ, and PA preferred; NY experience required.
• Experience in the healthcare industry preferred.
• Experience in the construction industry preferred.
• 5-7 years experience as a Workers' Compensation loss time claim adjuster.