Senior Workers Compensation Claim Specialist

MEMIC; City of Albany (NY); Presencial; USD 90.000 - 110.000; Jornada completa

Descripción de la vacante

MEMIC in New York seeks a Lost Time Claim Specialist with several years of workers’ compensation experience. You will manage complex lost time claims, ensuring compliance with New York regulations and delivering exceptional service to injured workers, policyholders, and agents.

You will investigate, evaluate, and resolve claims, administer benefits, coordinate care, and maintain high-quality files while staying current on state laws and trends.

Formación

• 3+ years of Lost Time Claim handling experience in New York.
• Strong knowledge of workers’ compensation claims and jurisdictional compliance.
• Excellent verbal and written communication skills.
• Adaptable with the ability to manage time and priorities effectively.
• Strong attention to detail and organizational skills.
• Strong team player with excellent customer service skills.

Responsabilidades

• Investigate, evaluate, and resolve medical-only and lost time claims.
• Serve as a point of contact for insureds, injured workers, agents, brokers, attorneys and stakeholders to gather information and provide updates.
• Administer medical and indemnity benefits in compliance with state workers’ compensation statutes and MEMIC’s practices.
• Maintain organized, high-quality claim files per company policies.
• Implement Managed Care strategies, coordinate rehabilitation plans, process medical bills, and monitor progress.
• Interact with state and federal boards and commissions to ensure reserves and regulatory compliance.
• Stay updated on state laws and workers’ compensation trends through MEMIC training and external certifications.

Conocimientos

Lost Time Claims

Communication

Time Management

Attention to Detail

Team Player

Customer Service

Descripción del empleo

New York

Are you an experienced insurance professional ready to take on a specialized role? MEMIC is seeking a Lost Time Claim Specialist with several years of experience handling workers’ compensation claims in New York.

In this role, you will manage complex lost time claims, ensure compliance with state-specific regulations, and deliver exceptional service to injured workers, policyholders, and agents. Your expertise will help maintain MEMIC’s reputation for excellence in claims management.

What You’ll Do

• Claims Management: Investigate, evaluate, and resolve medical-only claims and lost time claims.


• Communication: Serve as a point of contact for insureds, injured workers, agents, brokers, attorneys, and other stakeholders to gather necessary information and provide timely updates.


• Benefit Delivery: Administer medical and indemnity benefits in compliance with state workers’ compensation statutes and MEMIC’s best practices.


• Quality Assurance: Maintain organized and high-quality claim files in accordance with company policies and procedures.


• Managed Care Coordination: Implement Managed Care strategies, coordinate rehabilitation plans, process medical bills, and monitor case progress.


• Legal & Regulatory Compliance: Interact with state and federal boards and commissions to ensure proper reserves and compliance with laws and regulations.


• Ongoing Learning: Stay updated on state laws and workers’ compensation trends through MEMIC-provided training and external certifications like WCP or Claims Law (AEI).

What You Bring

• 3+ years of Lost Time Claim handling experience in New York


• Strong knowledge of workers’ compensation claims and jurisdictional compliance.


• Excellent verbal and written communication skills.


• Must be adaptable and have the ability to manage time and priorities effectively.


• Strong attention to detail and organizational skills.


• Strong team player with excellent customer service skills.

MEMIC is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, age, disability, genetics, gender identity, veteran's status, sexual orientation, or any other characteristic protected by law. Additionally, we are committed to providing an inclusive and accessible recruitment experience for all candidates. If you need a reasonable accommodation during the interview process, please contact us at [e-mail].

To ensure an equitable and authentic interview process, candidates should not use AI or chatbot tools during the live interview or phone screen. We welcome any preparation you choose to do beforehand, but all responses shared during the interview must be your own.

Note: MEMIC does not offer Stem-OPT EAD Extension for this role.

Check out our benefit offerings here! Targeted salary range: $90,000-$110,000

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