Position Overview
Now Hiring! Worker's Compensation Claims Examiner
Location: Spring Valley, NY 10977
Compensation: $80,000 - $115,000 depending on qualifications
What's in it for You:
Medical, Dental, Vision Benefits
Competitive Compensation
401K eligible upon 1st day of employment
FSA & DCA Accounts
Career advancement opportunities in an expanding company
Job Summary : Highview National Insurance is an insurance carrier that provides workers' compensation coverage. We pride ourselves on having an exceptional team environment, with multiple avenues for growth opportunities. We are currently hiring for a new
Claims Examiner
to be responsible for investigation and management of workers' compensation claims in Pennsylvania and New Jersey, including medical management and litigation management to drive claims to closure while working to actively mitigate exposure for the Company. If hired as
Claims Examiner , you would be expected to work full-time [40 hours per week] and work on-site in our office at least two days per week in a hybrid capacity.
What You'll Do :
Responsible for investigation, and management of workers' compensation claims in multiple jurisdictions. This will include medical management and litigation management to drive claims to closure while working to actively mitigate exposure for the Company.
This position will coordinate between nurse case managers, counsel, external vendors, and insureds to ensure efficient and proactive claims handling.
Reports directly to the Director of Risk & Claims
This is a full-time and hybrid position (two days per week in the office)
Minimal in-person visits to insureds may be required.
Responsible for completing and documenting initial loss investigations to determine compensability.
Establish initial and subsequent reserves to ensure reserves are adequate for anticipated exposure.
Review medical bills for a causal relationship to reported claim.
Liaison with insureds, nurse case managers, and counsel to oversee management of claims and bring them to closure and facilitate full or transitional duty return to work.
Develop and maintain action plans to ensure reserve adequacy and bring claims to a timely resolution.
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 the insured and counsel on strategies for successful claim closure/resolutions.
What You'll Need :
Minimum of 5 years' experience adjusting worker's compensation claims in multiple jurisdictions, specifically Pennsylvania and New Jersey.
Demonstrates accuracy, attention to detail, and thoroughness.
Works effectively in a fast-paced environment while providing a high level of customer service.
Ability to work independently on assigned tasks as well as accept direction on given assignments.
Effective organizational skills.
Who We Are: Highview National Insurance: www.highviewins.com Highview National is an insurance company with decades of experience in commercial insurance and risk management. We're focused on making the process of procuring insurance as simple and as smooth as possible.
This list of functions, duties, responsibilities, and skills is not intended to be all-inclusive, and the employer reserves the right to assign additional duties and responsibilities as necessary.
Highview National Insurance is an Equal Opportunity Employer. Highview National Insurance does not discriminate based on race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status, or any other basis covered by appropriate law. All employment is decided based on qualifications, merit, and business need.
Pay Range
USD $80,000.00 - USD $115,000.00 /Yr.
