Senior Workers’ Comp Specialist: Complex Claims Expert

Westchester Medical Center Health Network; Town of Mount Pleasant (NY); On-site; USD 70,000 - 110,000; Full time

Job summary

Westchester Medical Center Health Network seeks a Workers’ Compensation Specialist to independently investigate, evaluate, and resolve complex NY state claims under the direction of the Sr. Director of Leave Management.

The role manages cases from inception to closing, ensuring compliance with statutes, policy provisions, and organizational guidelines. Responsibilities include acting as subject matter expert, serving as primary contact for injured employees, coordinating with adjusters and

Qualifications

• Minimum of 5 years’ experience handling New York State workers’ compensation claims.
• Associates Degree required; Bachelor's degree preferred.
• Experience with regulatory compliance and claims processing.

Responsibilities

• Investigates and resolves complex NY workers’ compensation claims.
• Serves as primary contact for injured employees throughout the claim.
• Administers indemnity and medical benefits for valid claims.
• Provides guidance on claim management and settlement strategies.
• Maintains thorough documentation and diary for all claims.
• Coordinates with supervisors and adjusters to progress claims.
• Collaborates with risk management to optimize leave and claim processes.
• Ensures timely reporting to vendors or state agencies.

Skills

Microsoft Office

Time management

Organizational skills

Communication skills

Negotiation skills

Analytical thinking

Regulatory knowledge

Team collaboration

Education

Associates degree

Bachelor’s degree preferred

Tools

Spreadsheets

MS Excel

Job description

Westchester Medical Center Health Network seeks a Workers’ Compensation Specialist to independently investigate, evaluate, and resolve complex NY state claims under the direction of the Sr. Director of Leave Management.

The role manages cases from inception to closing, ensuring compliance with statutes, policy provisions, and organizational guidelines. Responsibilities include acting as subject matter expert, serving as primary contact for injured employees, coordinating with adjusters and