WC CLAIMS ADJUSTER

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    "requisitionDescription": "<div><div><p><strong>Summary</strong></p><p id=\"isPasted\">Review and process mail (Board decisions, attorney correspondence, and authorization request). Review and issue timely payments of awards from the Workers&#39; Compensation Board.</p><p><strong>Essential Duties &amp; Responsibilities</strong></p><p>&bull; Maintain an open file case load (approximately 150); and a 1:1 closing ratio.</p><p>&bull; Handle a case load of catastrophic aims, PPD and high cost claims.</p><p>&bull; Provide reserve and settlement authority ($30,000), Refer higher limit Files to the manager for authority.</p><p>&bull; Resolve and settle cases with Workers&#39; Compensation attorneys and HIC hearing reps; request appeals where applicable.</p><p>&bull; Assign cases for ME, Investigations and Case Management.</p><p>&bull; Negotiate and settle outstanding medical bills.</p><p>&bull; Settle cases through Section 32 and SLU process.</p><p><span id=\"isPasted\" style=\"color: rgb(65, 65, 65); font-family: sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;\">&bull;</span> Complete 3 point contact (claimant, insured and provider) within 48 hours.</p><p>&bull; Timely filing of WCB forms to avoid penalties, Timely processing of Workers&#39; Compensation Board awards.</p><p>&bull; Review medical bills for payment and causal relationship.</p><p>&bull; Issue timely payments (bi-weekly) including CCP Indemnity and awards, Maintain a daily diary of pending.</p><p>&bull; Follow-up with subrogation (loss transfer and 3rd party claims).</p><p><strong>Other Duties&nbsp;</strong></p><p>This job description in no way states or implies that these are the only cuties to be performed. You will be expected to follow any other job-related instructions and to perform other job-related duties as requested by your supervisor.</p><p><strong>Qualifications&nbsp;</strong></p><p>At least 5 years proven, current experience as a NY workers&#39; compensation claims examiner/adjuster: detailed working knowledge of the additions to the medical treatment guidelines effective 2014.</p><p><strong>Supervisory Responsibilities&nbsp;</strong></p><p><strong>Physical Demands&nbsp;</strong></p><p>While performing the duties of this job, the employee is frequently required to sit for long periods while using a computer with keyboard, screen and mouse; talk, listen on the telephone and in person; read and write; apply logic and focus attention in the presence of distraction, Occasional requirements are to stand or walk for brief periods,&nbsp;</p><p><strong>Training&nbsp;</strong></p><p>On-the-job training including but not limited to Imageright and AS400.</p><p><strong>Decision Making&nbsp;</strong></p><p><strong>Financial Responsibilities&nbsp;</strong></p><p>Reserve authority up to $30k.</p><p><strong>Communication&nbsp;</strong></p><p>Effective verbal, written and interpersonal communication skills.</p><p><strong>Results of Action&nbsp;</strong></p><p>Successful actions will result in the complete, timely and accurate payments of awards.</p><p><span id=\"isPasted\" style=\"color: rgb(65, 65, 65); font-family: sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;\"><strong>Equipment Used&nbsp;</strong></span></p><p>Equipment used is primarily a personal computer, peripherals and related software.</p><p><strong>Work Environment</strong>&nbsp;</p><p>The work environment consists of indoor highly regulated, time sensitive, teamwork environment in a standard office setting utilizing a cubicle as a work station.</p></div></div>\n",
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