Claims Specialist
Hire Solutions
This position will primarily oversee Workers' Compensation claims from intake through resolution, with the opportunity to specialize in Commercial Auto and support select Property claims. You will act as a strategic partner with clients, ensuring carriers and defense counsel are held to the highest standards of performance and accountability, while providing excellent communication with our clients and internal stakeholders.
**Key Responsibilities**- - Serve as the primary liaison between insureds, brokers, carriers and defense counsel, to streamline communication and resolve roadblocks
- - Provide expert oversight of insurance carrier adjusters on Workers' Compensation claims
- - Perform in-depth claim reviews to determine compensability, reserves, and direct best claim strategy for optimal outcomes
- - Maintain rigorous diary system, tracking critical action items, reviewing hearing reports from defense counsel, and ensuring carrier compliance with New York Workers' Compensation Board timelines and requirements
- - Aggressively pursue timely completion of items outlined in Notices of Decision (NODs) and ensure carriers and clients meet all statutory obligations
- -Light duty oversight, including tracking active light duty claimants and working with providers, insureds and carriers to bring injured workers back to work.
- - Prepare and file key forms (C-11, C-240, etc.) and respond to Board inquiries and penalties
- -conduct claim reviews for settlement approval
- -conduct claim reviews with clients
- - Active New York State Adjuster License
- - Minimum 2 years of direct hands-on experience as a Workers' Compensation claims adjuster in New York
- - Proven track record managing complex New York Workers' Compensation claims through litigation and settlement
- - Strong working knowledge of New York Workers' Compensation Law, Board procedures, Section 32 settlements, and Medicare Set-Asides
- - Advanced proficiency with claim systems, document management, and diary/follow-up discipline
- **Preferred Qualifications**
- - 2+ years of New York Workers' Compensation adjusting experience
- - knowledge of Commercial Auto claims
- - Working knowledge of auto and Commercial Property claims
- **Core Competencies**
- - Strategic claim oversight and negotiation skills
- - Exceptional organizational skills with meticulous attention to detail and deadlines
- - Strong analytical ability to evaluate medical, legal, and indemnity exposures
- - Professional, confident communication with executives, attorneys, and claims professionals
- - Self-motivated, results-driven mindset in a meritocracy environment
- - Ability to apply claims oversight concepts to other jurisdictions
Vacancy posted 3 days ago
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