Senior Workers Compensation Claims Adjuster

Responsible for the prompt and efficient examination, investigation and settlement or declination of workers compensation insurance claims through effective research, negotiation and interaction with insureds and claimants, ensuring that company resources are utilized in a cost effective manner in the process. Essential Job Functions Review, process and conclude high exposure liability claims or those limited in exposure but occasionally complex in nature. Oversee and direct a majority of litigated or potentially litigated claims, directing and controlling the work and expenses of investigative services or attorneys. Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud and resolution potential. Conduct a thorough analysis of liability and damages. Continually assess exposure and evaluate for accurate reserves. Prepare Large Loss Reports and maintain ongoing claim updates. Complete quality investigations by gathering all pertinent information (recorded statements, review of police and medical reports, photographs and appraisals/estimates of damages, etc.). Determines if subrogation exists and takes steps necessary to initiate recovery efforts. Maintains appropriate financial accountabilities (reserving) and controls loss adjustment expenses. Document all correspondence, reports, discussions and decisions. Fulfill state licensing agreements/requirements (if applicable) and apply knowledge of state laws and regulations pertaining to the insurance industry. Provides quality service to all customers. Mentor less experienced staff members. Assist Supervisors and Claim Department with requested tasks or special projects. Position Qualifications Ability to manage relationships in a fast paced environment, while demonstrating persistence along with problem solving and decision making skills to work with customers through a variety of challenging situations. Good analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions. Good knowledge of claim procedures, policies, technology, state and federal laws and insurance regulations. Ability to multi-task and handle large volumes of work in a short period of time. Ability to communicate effectively and clearly, both orally and in writing. Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently and exhibit good common sense. Ability to work independently with self-initiative. Time management skills, organizational skills and ability to prioritize issues and tasks. Ability to effectively operate computer equipment and applications. Education/Experience College degree is not a prerequisite for this position; however employee should possess such skills and knowledge as are normally gained in the successful completion of a four-year college program. Maintain valid adjusters’ license(s) in states assigned or an ability to obtain same. Minimum of two year’s experience in job-related functions or equivalent. Insurance coursework (e.g. IIA, CPCU, SCLA and AEI) is beneficial. Good knowledge of insurance theory and practices; insurance contracts and their application Workers Compensation experience is a must , as well as, handing claims in NY. The salary range for this role is $86,000- $105,000/year. This range is only applicable for jobs to be performed in New York. Base pay offered may vary depending on, but not limited to education, experience, skills, geographic location, travel requirements, sales or revenue-based metrics. This range may be modified in the future. #J-18808-Ljbffr