Job Description

Brown & Brown is seeking a WC Loss Time Claims Adjuster to join our growing team!

The role of the WC Loss Times Claims Adjuster is to manage Workers’ Compensation claims within specific limits and authority.

How You Will Contribute:

• Investigate and gather information to determine compensability by conducting three-point contact interviews with the employer, claimant, and healthcare provider.
• Secure and file necessary documents, including FROI & SROI forms with the NYS Workers’ Compensation Board, claimant and claimant’s attorney.
• Establish reserves, authorize payments & treatment within the NYS Medical Treatment Guidelines, under a set of authority.
• Examine and authorize payment of medical bills.
• Recognize and refer cases when IMEs are indicated.
• Prepare and instruct counsel to defend our interests for hearings at the NYS WC Board.
• Respond to written and telephone inquiries from claimants, clients, attorneys, doctors & vendors.
• Establish proper cost containment techniques; vendor referrals, recoveries & strategic case planning.
• Recognize cases that meet the criteria for reporting to the Excess Carrier.
• Negotiate settlements.
• Control the disposition of the claim process from investigation to settlement.

Licenses & Certifications:

• New York State License is required or obtained within 6 months of employment.

Skills & Experience to be Successful:

• Exceptional telephone demeanor.
• Ability to maintain a high level of confidentiality.
• Prior experience in adjusting New York State workers’ compensation claims.

Preferred:

• Bachelor’s degree is preferred.
• Volunteer Firefighters, 207(a) and 207(b) claims handling experience are preferred.

Job Tags

Similar Jobs