PPD Claims Associate, Temp

Jimmy Jazz; New York (NY); On-site; USD 57,000 - 77,000; Part time

Job summary

The Joint Industry Board of the Electrical Industry (JIB) is seeking a Temporary PPD Claims Associate to perform a range of claims duties, including review, settlement negotiations, and reporting to excess carriers and senior management. This onsite role requires familiarity with NYS workers’ compensation forms and the ability to manage reserves and payments.

Responsibilities include scheduling alive and well checks, coordinating with attorneys and nurses, and ensuring timely filing of forms.

Qualifications

• Four-year college degree preferred or equivalent experience
• Familiarity with NYS workers' compensation forms
• Minimum 1 year of workers’ compensation examiner experience
• Extensive knowledge of NYS Disability and Worker’s Compensation laws
• Proficient in Word & Excel and able to work independently

Responsibilities

• Regular review of all resolved classified PPD cases both pre-cap and post-cap for settlement
• Negotiation of Section 32 settlements with attorneys, subject to approval by Supervision
• Provide status reports to Excess carrier on all previously classified cases requiring updates
• Scheduling annual (semi-annual) alive and well checks on all classified cases, and necessary follow ups including surveillance in appropriate cases
• Responsible for maintenance of adequate reserves on all classified cases
• Provide status reports to Senior Management on any and all cases on an as-needed basis
• Process payments utilizing software system on select cases
• Communicates with Excess carrier on cases where it applies
• Communicate with the members on various issues that may occur
• May schedule an IME if needed to review need for treatment
• Occasionally authorize medications for treatment
• Performs other duties and special assignments as deemed necessary
• Review of electrical industry workers compensation claims and determine compensability
• File all required workers compensation forms timely
• Oversee medical management and investigations of claims
• Calculate payroll and compensation payment based on set guidelines
• Serve as liaison and interface with Magna Comp nurse and claimant as part of the review process
• Assign cases for investigations and review progress
• Prepare workers compensation claim for long-term disability
• Ability to evaluate the degree of disability and scheduled loss value
• Maintains professional relationship with all appropriate parties involved with the claim.
• Refers cases as appropriate to management.
• Actively executes appropriate claims activities to ensure consistent delivery of quality claims service.
• Develops and manages claims through well-developed action plans, continues to monitor and work the action plan to timely and appropriate resolution
• Analyze and processes workers’ compensation claims by investigating, research, and gathering information to determine the exposure on the claim
• Perform other duties and special assignments as necessary

Skills

Interpersonal skills

Communication skills

Organizational skills

Microsoft Word

Excel

Education

Bachelor's degree or equivalent

Tools

Microsoft Word

Excel

Job description

• Location 158-11 HARRY VAN ARSDALE JR AVE,Flushing, NY, 11365,United States
• Base Pay $36.96 / Hour
• Industry NYS Disability, Occupational Health & Safety, Workers Compensation
• Employee Type Temp
• Manage Others No

Description

JOB DESCRIPTION

Reporting to the Assistant Director, under close direction and oversight, the Temporary PPD Claims Associate will perform various duties including but not limited to:

• Regular review of all resolved classified PPD cases both pre-cap and post-cap for settlement
• Negotiation of Section 32 settlements with attorneys, subject to approval by Supervision
• Provide status reports to Excess carrier on all previously classified cases requiring updates
• Scheduling annual (semi-annual) alive and well checks on all classified cases, and necessary follow ups including surveillance in appropriate cases
• Responsible for maintenance of adequate reserves on all classified cases
• Provide status reports to Senior Management on any and all cases on an as-needed basis
• Process payments utilizing software system on select cases
• Communicates with Excess carrier on cases where it applies
• Communicate with the members on various issues that may occur
• May schedule an IME if needed to review need for treatment
• Occasionally authorize medications for treatment
• Performs other duties and special assignments as deemed necessary

Serve as back up for active claims, in this capacity the Examiner will be responsible for the following duties:

• Review of electrical industry workers compensation claims and determine compensability
• File all required workers compensation forms timely
• Oversee medical management and investigations of claims
• Calculate payroll and compensation payment based on set guidelines
• Serve as liaison and interface with Magna Comp nurse and claimant as part of the review process
• Assign cases for investigations and review progress
• Prepare workers compensation claim for long-term disability
• Ability to evaluate the degree of disability and scheduled loss value
• Maintains professional relationship with all appropriate parties involved with the claim.
• Refers cases as appropriate to management.
• Actively executes appropriate claims activities to ensure consistent delivery of quality claims service.
• Develops and manages claims through well-developed action plans, continues to monitor and work the action plan to timely and appropriate resolution
• Analyze and processes workers’ compensation claims by investigating, research, and gathering information to determine the exposure on the claim
• Perform other duties and special assignments as necessary

This job operates in a professional office -- customer service environment. This role routinely uses standard office equipment such as desktop computers, phone, scanner, printer, keyboard, photocopiers, shredder and fax.

Physical Demands

Sedentary work environment with physical demands described are representative of those that must be met by an employee to successfully perform the functions of this job. This would require the ability to lift files, pull files/forms/books, stand, bending, shred documents, open/close filing cabinets as necessary.

Position Type/Expected Hours of Work

This is a temporary onsite 35 hours per week, non-exempt position. Days and hours of work are Monday through Friday 8:30AM-4:30PM.

Flexibility:

Must be able to work overtime when necessary.

Travel

No travel is expected for this position.

Requirements

• A four-year college degree preferred, or a combination of school and/or equivalent experience
• Familiarity with all NYS workers compensation forms
• A minimum of 1 years of experience as a workers’ compensation examiner required
• Extensive knowledge of NYS Disability and Worker’s Compensation laws
• Excellent interpersonal, organizational, and communication skills
• Working knowledge of Microsoft Word & Excel
• Must be able to work independently and collectively
• Familiarity with WC claim reserve
• Must possess the ability to make sound judgment
• Strict confidentiality

Other Duties/Special Projects

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Reasonable Accommodations Statement

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable Accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

HIPAA Compliance Required

Summary

The Joint Industry Board of the Electrical Industry (JIB) was established in 1943 by the International Brotherhood of Electrical Workers, Local Union No. 3 and employers affiliated with the National Electrical Contractors Association. Its mission is to promote harmony between employees and employers, administer benefits for members and their families and improve competitiveness through progressive management, education, training and technology.