Lost Time Adjuster
Absolute Staffing & Consulting Solutions
- Poughkeepsie, NY
We are seeking to fill a temporary Workers' Compensation Lost Time Adjuster positions. Primary office location is in Poughkeepsie, NY but will be remote work. This is a temporary position for 3-6 mo but could potentially go permanent. Start date April 1, 2021.
As a member of the claims team, you will use your knowledge and experience to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.
- Promptly investigates all assigned claims with minimal supervision, including those of a more complex nature
- Determines coverage, compensability and potential for subrogation recovery
- Ensures timely denial or payment of benefits in accordance with jurisdictional requirements
- Within granted authority, establishes appropriate reserves with documented rationale, maintains and adjusts reserves over the life of the claim to reflect changes in exposure
- Negotiates claims settlements within granted authority
- Establishes and implements appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition
- Works collaboratively with nurse professionals to develop and execute return to work strategies
- Selects and manages service vendors to achieve appropriate balance between allocated expense and loss outcome
- Maintains a working knowledge of jurisdictional requirements and applicable case law
- Demonstrates technical proficiency through timely, consistent execution of best claim practices
- Communicates effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues
- Provides a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account- specific sessions
- Authorizes treatment based on the practiced protocols established by statute or the Managed Care department
- Bachelor's degree and/or three or more years of equivalent work experience required in an insurance related industry required
- Associate in Claims (AIC) Designation or similar professional designation desired
- Familiarity with medical terminology and/or Workers' Compensation
- Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously
- Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details
- Strong verbal, written communication skills and customer service skills gained through previous work experience
- Computer literacy, including working knowledge of MS Office Product Suite, i.e. WORD, Excel, PowerPoint
- Ability to travel for business purposes, approximately less than 10%.
- Working knowledge of Workers Compensation regulations for NY.
****New York license is required
Monday, March 22, 2021