[ref. a5340500] Trenton - Remote Workers' Compensation Claim Adjuster - NY Jurisdiction

Overview:

Workers' Compensation Claim Consultant (Remote) – NY Jurisdiction

This fully remote position offers you flexibility, career growth, and the chance to be part of an organization that puts people first.

Experience Required: 5+ years of workers' compensation claims experience, with a NY adjuster's license required

Why CCMSI?

Culture: We embrace a culture where employees are valued and treated as partners, rooted in our Core Values of integrity, passion, and enthusiasm. Certified as a Great Place to Work, our employee satisfaction and retention rates are in the 95th percentile.

Career Development: At CCMSI, we support your career ambitions with structured growth opportunities, internal training programs, and mentorship. This role also offers an excellent pathway to more senior claim positions.

Work-Life Balance: Enjoy manageable caseloads that allow you to excel while maintaining a healthy work-life balance.

Generous Benefits:

• Paid Time Off: Start with 4 weeks of PTO in your first year, plus 10 paid holidays.
• Comprehensive Health Coverage: Medical, Dental, Vision, Life Insurance, and Critical Illness plans.
• Financial Security: 401(k) plan, Employee Stock Ownership Plan (ESOP), Short and Long-Term Disability.

Your Role:

As a Workers' Compensation Claim Consultant, you will:

• Conduct thorough investigations and adjust claims within the NY jurisdiction.
• Manage a dedicated client desk, ensuring client satisfaction through exceptional claims handling.
• Be responsible for maintaining the quality of claims services, adhering to both CCMSI standards and client expectations.
• Receive support and advanced training to prepare for future senior-level opportunities.

Take the next step in your career and join a company that invests in your success. Apply today to become a part of CCMSI’s winning team!

Responsibilities:

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations within established reserve authority levels.
• Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
• Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
• Assess and monitor subrogation claims for resolution.
• Review and maintain personal diary on claim system.
• Client satisfaction.
• Prepare reports detailing claim status, payments and reserves, as requested.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
• Prepare newsletter articles, as requested.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Handle more complex and involved claims than lower level claim positions with minimum supervision.
• Conduct claim reviews and/or training sessions for designated clients, as requested.
• Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
• Performs other duties as assigned.

Qualifications:

Education and/or Experience

Five or more years claims experience is required.

Computer Skills

Proficient using MicroSoft Office products such as Word, Excel, Outlook, etc.

Certificates, Licenses, Registrations

NY adjuster's license required.

CORE VALUES & PRINCIPLES

Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.

CCMSI is an Affirmative Action/Equal Employment Opportunity employer offering an excellent benefit package included Medical, Dental, Vision, Prescription Drug, Flexible Spending, Life, ESOP and 401K.

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