New York Workers Comp Claims Examiner Position Available In [Unknown county], New York

New York Workers Comp Claims Examiner 4.1 4.1 out of 5 stars New York State

• Remote Remote
• $40•47/hr.

NYS License Required. 5+ years of NY claims handling required.

Summary:

Reports directly to the unit Claims Supervisor. In accordance with applicable statutes and in keeping with company rules, regulations, and established performance objectives, is responsible for effectively managing to conclusion an assigned inventory of claim files.

Essential Duties and Responsibilities:

Perform a three-point contact on all new losses within 24 hours of receipt of the claim to include the claimant, employer, and treating physician to document relevant facts surrounding the incident itself as well as disability and treatment status. Thoroughly and accurately gather evidence regarding ongoing case facts and relevant information necessary for establishing compensability, the need for disability payments, the use of vendors, medical and expense payments, and the reason the claim is still open. Assure that all assigned indemnity claims have an up to date plan of action outlining activities and actions anticipated for ultimately resolving the claim. Form a partnership with the medical case manager to maximize early return to work potential thereby reducing the need for extended disability payments, vocational rehabilitation, and other protracted claims costs. Initiate the referral to the SIU of cases with suspected fraud. Aggressively pursue subrogation from culpable third parties, contributions on multiple defendant cases, and apportionment when there is pre-existing disability. Assure that the claim file is handled totally in accordance with applicable statutes as well as in-force service contracts and company guidelines. Review and approve all vocational rehabilitation plans. Establish, monitor, and adjust monetary case reserves when warranted and in strict accordance with assigned authority levels. Review all medical bills for appropriateness prior to referral to internal claims service for payment and posting to the claim file. Exhibit and maintain a courteous and helpful attitude and project a professional image on behalf of the company. Respond to telephone messages and inquiries within 24 hours of receipt and to written inquiries within one week of receipt. Requires a working knowledge of the Labor Code of the State of New York as it pertains to workers compensation claims and the legal requirements for handling them. Litigation Management

• Direct, manage, and control the litigation process.

Handles other duties and tasks as deemed appropriate by the Supervisor or Manager.

Requirements Competency:

To perform the job successfully, an individual should demonstrate the following competencies: Problem Solving

• Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Uses reason even when dealing with emotional topics. Customer Service
• Manages difficult or emotional customer situations; Responds promptly to customer needs; Responds to requests for service and assistance; Meets commitments. Interpersonal
• Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others’ ideas and tries new things. Team Work
• Supports everyone’s efforts to succeed.

Qualification Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or

Experience:

Bachelor’s degree (B. A.) or equivalent from four-year college or; or 3-5years related experience & training, or equivalent combination of education and experience. Here at Canon Recruiting, People are our priority, and we are committed to Include Diversity in every segment of who we are. It is only through our Diversity, we are made a stronger organization, and increase our ability to provide top tier candidates that our clients have come to know Canon for. We have an inclusive environment all employees are celebrated for their unique differences. The different perspectives and experiences of our workforce give us the competitive advantage that is essential for success in an ever-changing market. By promoting inclusion with the same enthusiasm, we devote to quality and competency, and using the experience from a diverse assortment of backgrounds and experiences, Canon is able to improve the services and value we deliver to clients, employees, and customers. At Canon, Diversification and Inclusiveness are much more than a corporate ambition; they are a critical component in our daily corporate life. Canon Recruiting is committed to a diverse and inclusive workplace. Canon Recruiting is an equal opportunity employer and does not discriminate on the basis of race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status. The pay range for this position is listed above. Base pay information is based on market location. We will consider for employment qualified applicants with arrest and conviction records. Our range of benefits may include health care and 401(k) savings plans. For individuals with disabilities who would like to request an accommodation, please email hr@canonrecruiting.com