Lost Time WC Claims Examiner (Litigation-Ready)

Packard Claims Administration; Town of Florida (NY); On-site; USD 55,000 - 75,000; Full time

Job summary

Packard Claims Administration is a fast paced TPA specializing in Workers' Compensation claims, seeking a Lost Time Claims Examiner with 2+ years of litigation experience. The role requires maintaining a Florida Adjuster license and handling claims through review of coverage, compensability, and potential subrogation recovery.

The candidate will investigate claims with minimal supervision, communicate with all parties, set reserves, and work with nursing to implement return-to-work strategies,

Qualifications

• High school diploma required.
• 2+ years related claims experience required.
• Licensed and/or certified in all states where claims are handled.
• Extensive knowledge of industry standards and practices; computer experience with claims software.

Responsibilities

• Must have and maintain Florida Adjuster license (620 All Lines License).
• Determine coverage, compensability and potential for subrogation recovery on assigned claims.
• Investigate claims with minimal supervision, from simple to complex cases.
• Communicate timely with all parties involved per company policies.
• Set, maintain and adjust reserves for the life of the claim.
• Collaborate with in-house nursing team to develop return-to-work strategies.
• Document and execute action plans to move claims toward final resolution.
• Negotiate settlements within desk authority.
• Know jurisdictional requirements to ensure timely denial or payment of benefits.
• Maintain continuing education requirements for assigned jurisdictions.
• Stay up-to-date on case laws for each jurisdiction.
• Develop extensive knowledge of assigned claims for deposition/mediation preparation.
• Act in accordance with company policies and procedures.

Skills

Litigation experience

Claims handling

Education

High school diploma

Job description

Packard Claims Administration is a fast paced TPA specializing in Workers' Compensation claims, seeking a Lost Time Claims Examiner with 2+ years of litigation experience. The role requires maintaining a Florida Adjuster license and handling claims through review of coverage, compensability, and potential subrogation recovery.

The candidate will investigate claims with minimal supervision, communicate with all parties, set reserves, and work with nursing to implement return-to-work strategies,