Worker Compensation Claims Specialist

$65,000 - $65,000/Yr

Foundation Risk Partners - Rockville Centre, NY

Full-time - Entry Level

Rockville Centre, NY

Insurance Carriers and Related Activities

About the position

The Claims Specialist at Foundation Risk Partners is responsible for managing incoming workers' compensation claims under the supervision of the Vice President of Risk Management. This role involves processing claims, maintaining communication with various stakeholders, and ensuring accurate data management related to claims. The position requires strong organizational skills and attention to detail to effectively handle multiple tasks and maintain compliance with insurance regulations.

Responsibilities

• Receive and process incoming workers' compensation claims.
• Assist in the claims management process and manage communication regarding claims.
• Manage data extraction regarding potential claims from various communication sources.
• Examine and evaluate claims for denial, subrogation, and possible fraud.
• Enter claims into the system and review/update information as necessary.
• Assist in maintaining all medical documentation and records related to workers' compensation cases.
• Make and maintain contacts with clients, adjusters, employees, and providers.
• Report claims to the carrier and the VP of Risk Management.
• Manage correspondence, including answering emails and phone calls, and noting files.
• Participate in claims reviews with client representatives when needed.
• Ensure all claimants complete necessary paperwork regarding their claims.

Requirements

• 2 years of insurance industry experience preferred.
• Associates degree preferred, or equivalent years of experience.
• Strong computer literacy.
• Knowledge of insurance-related laws and medical and legal terminology.
• Excellent written and oral communication skills.
• Excellent organizational skills with a strong sense of accuracy and attention to detail.
• Ability to exercise tact and discretion in handling confidential material.
• Ability to manage multiple projects, tasks, and priorities effectively.

Benefits

• Comprehensive health-related benefit options including medical, vision, and dental.
• 401(k) with company match.
• Company paid life insurance.
• Short-term and long-term disability insurance.
• Generous PTO policy starting at 18 days per year plus 10 paid holidays and 2 floating holidays.