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Senior Workers' Compensation Claims Examiner

Company: Hobson Associates
Location: Jersey City
Posted on: February 15, 2020

Job Description:

Senior Workers' Compensation Claims Examiner - Please note: Role is located in Jersey City with the ability to work remotely two days per week. - You must be able to commute to the Jersey City office the other three days. - Responsibilities: Under limited supervision, reviews, evaluates, negotiates and processes WC Claims of serious to significant complexity, makes recommendations for resolution, and litigation management as appropriate. Has contact with agents, claimants, and policyholders. The position is located in our Jersey City Office. Duties and Responsibilities: Analyzing and processing workers' compensation claims by investigating and gathering information to determine the exposure on the claims involving multiple jurisdictions with a concentration in the Tri-State area. Calculates and assigns timely an appropriate reserve to claims and continues to manage reserve adequacy throughout the life of the claim. Develops and manages claims though well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution. Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level. Prepares necessary state filings within statutory limits. Actively manages the litigation process; ensures timely and cost-effective claims resolution. Participate in claim reviews, which will require limited travel. Coordinates vendor referrals for additional investigation and/or litigation management. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims. Managing claim recoveries of all types, including but not limited to subrogation, Second Injury Fund recoveries, and Social Security offsets. Frequently communicates with all appropriate parties involved with the claim. Maintains professional client relationships. Actively executes appropriate claims activities to ensure consistent delivery of quality claims services. Proactively manage all litigated claims by clearly documenting the litigation plan and budget, retaining competent counsel, communicating with counsel on a regular basis and clearly documenting the litigation action plan and strategy. - Qualifications: Bachelor's degree or equivalent work experience of at least 5 years in investigating and adjusting workers compensation claims. Must have extensive understanding of WC Statutory benefits and state regulatory requirements in multiple jurisdictions. Working knowledge of Excel, Word, and general computer skills. Adjuster license required in area of adjusting specialty. - Ideal candidate will work from the Jersey City office at least 3 days a week. - Skills: Demonstrates strong written and oral communications skills. Ability to draft communications that are clear, concise, complete and professional. Negotiation skills mandatory, and ability to interact with all levels of the organization. Demonstrates organizational skills while working on multiple projects. Resumes and inquiries should be directed to Angela Hatt. - Contact information below. All inquiries are kept confidential. Angela Hatt Executive Recruiter Hobson Associates 203-439-7833 -

Keywords: Hobson Associates, Jersey City , Senior Workers' Compensation Claims Examiner, Other , Jersey City, New Jersey

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