Senior Workers' Compensation Claims Examiner | Remote

Job Description

Job Description

Our client is seeking an experienced Senior Workers' Compensation Claims Examiner to join a growing claims operation. This position is ideal for a knowledgeable claims professional who has extensive experience handling New York Workers' Compensation claims and is comfortable independently managing complex indemnity files.

The successful candidate will oversee claims throughout their lifecycle, applying sound judgment, strong investigative skills, and a thorough understanding of New York Workers' Compensation regulations. This individual will work closely with injured employees, medical professionals, legal representatives, and other stakeholders to ensure claims are handled accurately, efficiently, and in compliance with applicable requirements.

Responsibilities:

• Independently oversee a portfolio of approximately 100-105 Workers' Compensation claims, including complex and high-exposure indemnity cases.

• Evaluate newly reported claims, gather relevant information, and establish appropriate strategies for resolution.

• Review medical documentation, employment information, and investigative findings to determine claim eligibility and appropriate benefits.

• Ensure claims decisions and benefit payments comply with New York Workers' Compensation laws and regulatory requirements.

• Coordinate medical care, review treatment requests, and address billing matters to support

Requirements:

• 4+ years of experience managing New York Workers' Compensation claims, including indemnity and complex claim exposures.

• Demonstrated experience handling New York Workers' Compensation claims.

• Active New York claims handling license required.

• Strong working knowledge of New York Workers' Compensation statutes, claims procedures, and regulatory requirements.

• Experience evaluating compensability, managing medical treatment, establishing reserves, and negotiating settlements.

• Ability to independently manage a substantial claims inventory while maintaining accuracy and meeting established deadlines.

• Experience coordinating with defense counsel and overseeing litigated claims.

Salary & Benefits

• $90,000 - $105,000 (depending on experience)

• Flexible work schedule offering work-life balance

• Comprehensive medical, dental, and vision insurance options

• 401(k) retirement savings plan with potential employer contributions

• Paid time off, vacation, and company-observed holidays