RB Professional Recruiting Services LLC
Claims Examiner
RB Professional Recruiting Services LLC, Spring Valley, New York, United States, 10977
RBPRSLLC is looking for candidates to fill the position of Claims Examiner. On-Site position in Spring Valley, NY. No visa sponsorships supported, no agencies please.
Top Reasons to Work with our client
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. Salary: $80,000 - $115,000/year
Top Reasons to Work with our client
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. Salary: $80,000 - $115,000/year