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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