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Workers Compensation Plant Rep III

Company: Advantage Technical
Location: Buffalo
Posted on: January 24, 2023

Job Description:

New opportunity with major OEM! Primary Workers' Compensation Claims Handler with a focus on excellent customer service, quality claims handling, and loss cost management. Plant-based position with hybrid work schedule to be considered.Position Description:

  • Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim
  • Ability to handle a full case load, with proven ability to handle cases of increased severity.
  • Workers' Compensation Lost Time claim handling experience
  • Manage claims through well-developed action plans to ensure timely and cost effective resolutions.
  • Calculate and assign timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
  • Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle clams within designated authority level.
  • Prepare necessary state fillings within statutory limits.
  • Coordinate vendor referrals for additional investigation and/or litigation management.
  • Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
  • Manage claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
  • Report claims to the excess carrier.
  • Communicate claim activity and processing with the claimant and the client.
  • Ensure claim files are properly documented and claims coding is correct.
  • Refer cases as appropriate to supervisor and management.Skills Preferred:
    • Excellent oral and written communication skills.
    • PC literate, including Microsoft Office products.
    • Analytical and interpretive skills.
    • Strong organizational skills.
    • Good interpersonal skills.
    • Excellent negotiation skills.
    • Ability to work in a team environment.Experience Required:
      • 3 years of New York claims adjusting experienceEducation Required:
        • College degree and 3 years of New York claims management experience or equivalent combination of education and experience preferred.
        • High school diploma and 3 years related claims experience accepted.
        • In possession of or working towards New York independent adjuster license.
        • Extensive knowledge of accepted industry standards and practices.
        • Computer experience with related claims and business software.

Keywords: Advantage Technical, Buffalo , Workers Compensation Plant Rep III, Professions , Buffalo, New York

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