C. WinChell Agency
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Job Title : Senior Claim Specialist - Workers Compensation
   Jobcode : 20898
   Description : Examine claims data and conduct investigations into routine and moderately complex claims to determine coverage, compensability, subrogation and benefits under moderate supervisory direction. Adjust and manage claims within the limit of assigned authority. Receive lost time and complex medical only assignments for the state of NY. Verify and determine applicability of coverage. Initiate 24 hour contact with employer, employee and 48 hour contact with attending physician. Handle catastrophic claims with supervisory oversight. Conduct telephone investigations. Evaluate and adjust claims within the limits of authority. Consult with Claim Manager on claims when needed. Make assignments to nurse case management when indicated, monitoring their billing and performance. Set reserves for anticipated exposure up to authority limits. Complete mandatory RAW forms. Establish reserves requiring complex analysis with lifetime pharmacy and cost inflation. Coordinate return to work (RTW) and set target dates. Maintain diaries on maximum 3 month intervals. Document files in claims system. Review medical bills for causal relationship, medical bill charges for appropriateness and approve payments. Adhere to special account handling (SHI) instructions. Attend account meetings by telephone and in-person. Manage litigation on files.
   City : Parsippany Area
   State : NJ
   Requirement : Must be well versed in New York Workers Compensation statute. Bachelor’s Degree or equivalent experience. Minimum 8+ years experience handling New York workers compensation claims. Strong organizational and time management skills. Foreign language communications a plus. Excellent verbal and written communication skills are essential. Strong aptitude and knowledge of Microsoft Office and the ability to quickly learn new programs. Abide by departmental policies and procedures, including authority levels, to comply with risk management controls.
   Base Pay Low : $75,000
   Base Pay High : $85,000


Job Title : Workers Compensation Claims Examiner
   Jobcode : 20986
   Description : Interested in a growing company that specializes in Workers Compensation Risk Management for their diverse clients? Immediate position available for experienced New York Lost Time and Litigation Adjuster.
   City : Long Island
   State : NY
   Requirement : New York Workers Compensation experience. TPA or Broker experience preferred. New York Adjuster’s License preferred, but will assist in having it obtained. College degree desired as well. Experience with catastrophic injury claims needed.
   Base Pay Low : $70,000
   Base Pay High : $80,000