Senior Workers' Compensation Claims Examiner | Remote

King's Insurance Staffing; New Jersey; On-site; USD 90,000 - 105,000; Full time

Benefits offered by this job

Flexible work schedule

Medical, dental, and vision insurance

401(k) retirement plan

Paid time off and holidays

Job summary

King's Insurance Staffing is seeking an experienced Senior Workers' Compensation Claims Examiner to join a growing claims operation in New Jersey. The role focuses on NY WC claims with complex indemnity files, requiring independent management and sound judgment.

You will oversee 100–105 active claims, evaluate reports, and coordinate with defense counsel to ensure accurate reserves, proper benefits, and regulatory compliance under New York law.

Qualifications

• 4+ years of experience managing New York Workers' Compensation claims.
• Experience handling indemnity and complex claim exposures.
• Strong knowledge of New York WC statutes and procedures.
• Experience evaluating compensability and reserving medical treatment.
• Ability to manage a large claims inventory independently.
• Experience coordinating with defense counsel and litigated claims.

Responsibilities

• Independently oversee a portfolio of approximately 100-105 Workers' Compensation claims, including complex and high-exposure indemnity cases.
• Evaluate newly reported claims, gather relevant information, and establish appropriate strategies for resolution.
• Review medical documentation, employment information, and investigative findings to determine claim eligibility and appropriate benefits.
• Ensure claims decisions and benefit payments comply with New York Workers' Compensation laws and regulatory requirements.
• Coordinate medical care, review treatment requests, and address billing matters to support.

Skills

NY WC claims

Indemnity claims

Complex claims mgmt

Regulatory knowledge

Settlement negotiation

Defense counsel

Job description

Our client is seeking an experienced Senior Workers' Compensation Claims Examiner to join a growing claims operation. This position is ideal for a knowledgeable claims professional who has extensive experience handling New York Workers' Compensation claims and is comfortable independently managing complex indemnity files.

The successful candidate will oversee claims throughout their lifecycle, applying sound judgment, strong investigative skills, and a thorough understanding of New York Workers' Compensation regulations.

Responsibilities:

• Independently oversee a portfolio of approximately 100-105 Workers' Compensation claims, including complex and high-exposure indemnity cases.
• Evaluate newly reported claims, gather relevant information, and establish appropriate strategies for resolution.
• Review medical documentation, employment information, and investigative findings to determine claim eligibility and appropriate benefits.
• Ensure claims decisions and benefit payments comply with New York Workers' Compensation laws and regulatory requirements.
• Coordinate medical care, review treatment requests, and address billing matters to support

Requirements:

• 4+ years of experience managing New York Workers' Compensation claims, including indemnity and complex claim exposures.
• Demonstrated experience handling New York Workers' Compensation claims.
• Strong working knowledge of New York Workers' Compensation statutes, claims procedures, and regulatory requirements.
• Experience evaluating compensability, managing medical treatment, establishing reserves, and negotiating settlements.
• Ability to independently manage a substantial claims inventory while maintaining accuracy and meeting established deadlines.
• Experience coordinating with defense counsel and overseeing litigated claims.

Salary & Benefits

• $90,000 - $105,000 (depending on experience)
• Flexible work schedule offering work-life balance
• Comprehensive medical, dental, and vision insurance options
• 401(k) retirement savings plan with potential employer contributions
• Paid time off, vacation, and company-observed holidays