Manpower Group Inc.
Claims Examiner - Workers Compensation
Manpower Group Inc., Syracuse, New York, us, 13235
Experis IT ManpowerGroup has partnered with a leading Insurance Co in the Syracuse NY area for a Claims Examiner - Workers Compensation role to assist their team. This is a Permanent (Direct Hire) role.
Industry: Insurance Co
Title: Claims Examiner - Workers Compensation
Location: ONSITE – Syracuse NY
Duration: Permanent (Direct Hire)
Pay: $80-$90k
Job Description
Candidates must have at least two years of experience handling NY Workers’ Compensation lost time claims.
Must hold a valid NY Adjusters’ License.
To analyze complex or technically difficult workers' compensation claims to determine benefits due. This role involves managing high-exposure claims that may involve litigation and rehabilitation, ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. Additionally, the position includes identifying subrogation opportunities and negotiating settlements.
What You’ll Do
Claims Analysis and Processing
Analyze and process complex workers' compensation claims by investigating and gathering information to determine the exposure on the claim.
Manage claims through well-developed action plans to achieve appropriate and timely resolutions.
Negotiation and Settlement
Negotiate settlement of claims within designated authority.
Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim.
Calculate and pay benefits due; approve and make timely claim payments and adjustments; settle claims within designated authority level.
Regulatory Compliance
Prepare necessary state filings within statutory limits.
Manage the litigation process; ensure timely and cost-effective claims resolution.
Vendor Coordination
Coordinate vendor referrals for additional investigation and/or litigation management.
Utilize appropriate cost containment techniques, including strategic vendor partnerships, to reduce overall claims costs for clients.
Claims Recovery Management
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; respond to requests for directions in a professional and timely manner.
Communication and Documentation
Communicate claim activity and processing with the claimant and the client; maintain professional client relationships.
Ensure claim files are properly documented and claims coding is correct.
Refer cases as appropriate to supervisor and management.
Perform other duties as assigned.
Support the organization's quality program(s).
Travel as required.
You will need to have:
Education & Licensing
Bachelor's degree from an accredited college or university preferred.
Valid NY Adjuster's License required.
Experience
Three (3) years of claims management experience or an equivalent combination of education and experience required.
Skills & Knowledge
Subject matter expert in appropriate insurance principles and laws for the line-of-business handled, including recoveries, offsets, deductions, claim and disability duration, and cost containment principles.
Excellent oral and written communication skills, including presentation skills.
Proficient in PC applications, including Microsoft Office products.
Strong analytical and interpretive skills.
Excellent organizational and interpersonal skills.
Exceptional negotiation skills.
ManpowerGroup is committed to providing equal employment opportunities in a professional, high quality work environment. It is the policy of ManpowerGroup and all of its subsidiaries to recruit, train, promote, transfer, pay and take all employment actions without regard to an employee's race, color, national origin, ancestry, sex, sexual orientation, gender identity, genetic information, religion, age, disability, protected veteran status, or any other basis protected by applicable law.
Industry: Insurance Co
Title: Claims Examiner - Workers Compensation
Location: ONSITE – Syracuse NY
Duration: Permanent (Direct Hire)
Pay: $80-$90k
Job Description
Candidates must have at least two years of experience handling NY Workers’ Compensation lost time claims.
Must hold a valid NY Adjusters’ License.
To analyze complex or technically difficult workers' compensation claims to determine benefits due. This role involves managing high-exposure claims that may involve litigation and rehabilitation, ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. Additionally, the position includes identifying subrogation opportunities and negotiating settlements.
What You’ll Do
Claims Analysis and Processing
Analyze and process complex workers' compensation claims by investigating and gathering information to determine the exposure on the claim.
Manage claims through well-developed action plans to achieve appropriate and timely resolutions.
Negotiation and Settlement
Negotiate settlement of claims within designated authority.
Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim.
Calculate and pay benefits due; approve and make timely claim payments and adjustments; settle claims within designated authority level.
Regulatory Compliance
Prepare necessary state filings within statutory limits.
Manage the litigation process; ensure timely and cost-effective claims resolution.
Vendor Coordination
Coordinate vendor referrals for additional investigation and/or litigation management.
Utilize appropriate cost containment techniques, including strategic vendor partnerships, to reduce overall claims costs for clients.
Claims Recovery Management
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; respond to requests for directions in a professional and timely manner.
Communication and Documentation
Communicate claim activity and processing with the claimant and the client; maintain professional client relationships.
Ensure claim files are properly documented and claims coding is correct.
Refer cases as appropriate to supervisor and management.
Perform other duties as assigned.
Support the organization's quality program(s).
Travel as required.
You will need to have:
Education & Licensing
Bachelor's degree from an accredited college or university preferred.
Valid NY Adjuster's License required.
Experience
Three (3) years of claims management experience or an equivalent combination of education and experience required.
Skills & Knowledge
Subject matter expert in appropriate insurance principles and laws for the line-of-business handled, including recoveries, offsets, deductions, claim and disability duration, and cost containment principles.
Excellent oral and written communication skills, including presentation skills.
Proficient in PC applications, including Microsoft Office products.
Strong analytical and interpretive skills.
Excellent organizational and interpersonal skills.
Exceptional negotiation skills.
ManpowerGroup is committed to providing equal employment opportunities in a professional, high quality work environment. It is the policy of ManpowerGroup and all of its subsidiaries to recruit, train, promote, transfer, pay and take all employment actions without regard to an employee's race, color, national origin, ancestry, sex, sexual orientation, gender identity, genetic information, religion, age, disability, protected veteran status, or any other basis protected by applicable law.