Lovell, the largest safety group administrator in NYS, is looking for a Full-Time Entry-level Workers Compensation Claims Examiner/Clerk with excellent organizational and communication skills.
The position requires consistent excellent customer service to both internal and external Lovell stakeholders. Under the supervision of a manager, this position requires management of a caseload of medical only and/or permanent partial disability files while performing other administrative duties.
RESPONSIBILITIES:
- Ability to prioritize daily assignments for timely completion of tasks.
- Provide oversight of NYSIF s medical only or permanent partial disability claims in order to ensure that the claims are being properly handled in accordance with the NYS workers compensation laws and its rules and regulations.
- Generate weekly hearing reports to distribute to the legal staff for attendance at hearings.
- Must have understanding of the NYS workers compensation claims reporting requirements in order to file appropriate First Reports of Injury with NYSIF.
- Create claim files in the Lovell claims management system and assign files to the Claims Examiner handling the claim.
- Must be familiar with the Medical Treatment Guidelines and their application to ensure compliance and take appropriate action when the treatment falls outside Guidelines.
- Collaborates with NYSIF during all phases of the file to bring claim to resolution.
- Conducts preliminary investigation of claims and obtains necessary documents such as the employer/ witness statements, C-2, C-240, C-11s and medical reports.
- Keep files updated based on case developments and action plans. Communicates case developments to the employer and NYSIF. Documents action plan and findings in the Lovell claims system.
- Regularly review claim reserves and request NYSIF's adjustments based on the appropriate claim exposure(s).
- Collaborate with NYSIF in the claims management process to ensure NYSIF is appropriately scheduling IMEs and/or record reviews on a timely basis and taking appropriate claims action based on the IME results.
- Will be required to perform other administrative or claims (clerk) processing duties as necessary.
QUALIFICATIONS:
Required Education, Experience & Licensing
- BS/BA/Associate Degree from an accredited college/university or, a High School degree/GED with two years experience handling NYS workers compensation medical only or permanent partial disability (PPD) claims.
- NY State Adjuster License (Workers Compensation) a plus. Adjuster license is required within 1 year of employment start date.
Skills and Knowledge Requirements
Demonstrated problem solving and analytical skills
Ability to manage a medical only and permanent partial disability caseload
Strong interpersonal skills with the ability to work in teams and individually
Strong verbal and written communication skills
Must be able to provide excellent customer service
Strong organizational skills with the ability to work within tight timeframes and meet strict deadlines
Must have good computer skills and be proficient with Microsoft, Word, and Adobe
We offer a comprehensive and competitive benefits package in addition to compensation. The annual salary range for this role is $45,000 to $60,000 in addition to bonus potential, a 401(k) match, health benefits, paid time off and more. The final salary will be determined based on a variety of factors, including the individual's experience and qualifications.