Senior Workers' Comp Claims Examiner (Hybrid, NY)

Tristar Insurance; Philadelphia (Philadelphia County); Hybride; USD 85 000 - 95 000; Plein temps

Résumé du poste

Tristar Insurance in Philadelphia seeks an Experienced Claims Examiner to manage indemnity claims from inception to conclusion under established authority. Hybrid schedule with preference for local residents; remote option may be available for others in the area.

This role requires substantial interaction with clients, claimants, and management. You will handle a high-volume caseload with strong emphasis on regulatory knowledge and accurate medical terminology, using Word and Excel daily.

Qualifications

• Bachelor’s degree in a related field; 3+ years related experience or equivalent.
• Must be licensed to handle claims in NY.
• Strong written and verbal communication skills for clients and staff.

Responsabilités

• Manages a caseload of workers’ compensation files from inception to resolution.
• Determines compensability and administers benefits per state law and guidelines.
• Manages medical treatment and billing; authorizes as appropriate.
• Contacts claimants, providers, and vendors to resolve issues.
• Maintains diary system and documents file status for review.
• Recommends and coordinates with defense counsel when needed.

Connaissances

Regulatory knowledge

Medical terminology

Analytical skills

Communication skills

Complex claims management

Interpersonal skills

Formation

Bachelor's degree in related field

Outils

Word

Excel

Description du poste

Tristar Insurance in Philadelphia seeks an Experienced Claims Examiner to manage indemnity claims from inception to conclusion under established authority. Hybrid schedule with preference for local residents; remote option may be available for others in the area.

This role requires substantial interaction with clients, claimants, and management. You will handle a high-volume caseload with strong emphasis on regulatory knowledge and accurate medical terminology, using Word and Excel daily.