WC Loss Time Claims Adjuster

Brown & Brown Insurance; United States; Remote; USD 55,000 - 95,000; Full time

Benefits offered by this job

Health Benefits

401k; Student Loan Assistance; Tuition

Mental Health & Wellness

Paid Time Off & Holidays

Job summary

Brown & Brown is seeking a WC Loss Time Claims Adjuster to manage Workers’ Compensation claims within NYS guidelines, with focus on compensability, reserves, and settlements. The role requires NYS license within 6 months and experience adjusting NYS workers’ compensation claims.

Responsibilities include interviewing involved parties, filing required forms, authorizing payments, and coordinating hearings at the NYS WC Board while maintaining confidentiality and professional demeanor.

Qualifications

• Phon e etiquette and professional communication are essential.
• Maintain strict confidentiality in all claim information.
• Experience handling NYS workers’ compensation claims.

Responsibilities

• Investigate and determine compensability via interviews with employer, claimant and provider.
• Secure and file FROI & SROI forms with NYS WC Board and involved parties.
• Establish reserves and authorize payments within NYS guidelines.
• Examine and authorize medical bill payments.
• Refer cases for IMEs when indicated.
• Prepare and direct counsel for hearings at the NYS WC Board.
• Respond to inquiries from claimants, clients, attorneys, doctors and vendors.
• Apply cost containment through vendor referrals and recoveries.
• Identify cases requiring reporting to the Excess Carrier.
• Negotiate settlements and manage disposition from investigation to settlement.

Skills

Exceptional telephone demeanor

Confidentiality

New York State workers’ compensation

Education

Bachelor’s degree (preferred)

Job description

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.

Brown & Brown is seeking a WC Loss Time Claims Adjuster to join our growing team!

The role of the WC Loss Times Claims Adjuster is to manage Workers’ Compensation claims within specific limits and authority.

How You Will Contribute:

• Investigate and gather information to determine compensability by conducting three-point contact interviews with the employer, claimant, and healthcare provider.
• Secure and file necessary documents, including FROI & SROI forms with the NYS Workers’ Compensation Board, claimant and claimant’s attorney.
• Establish reserves, authorize payments & treatment within the NYS Medical Treatment Guidelines, under a set of authority.
• Examine and authorize payment of medical bills.
• Recognize and refer cases when IMEs are indicated.
• Prepare and instruct counsel to defend our interests for hearings at the NYS WC Board.
• Respond to written and telephone inquiries from claimants, clients, attorneys, doctors & vendors.
• Establish proper cost containment techniques; vendor referrals, recoveries & strategic case planning.
• Recognize cases that meet the criteria for reporting to the Excess Carrier.
• Negotiate settlements.
• Control the disposition of the claim process from investigation to settlement.

Licenses & Certifications:

• New York State License is required or obtained within 6 months of employment.

Skills & Experience to be Successful:

• Exceptional telephone demeanor.
• Ability to maintain a high level of confidentiality.
• Prior experience in adjusting New York State workers’ compensation claims.

Preferred:

• Bachelor’s degree is preferred.
• Volunteer Firefighters, 207(a) and 207(b) claims handling experience are preferred.

Pay Range

$55,000 - $95,000 Annual

The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role.

Teammate Benefits & Total Well-Being

We go beyond standard benefits, focusing on the total well-being of our teammates, including:

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
• Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
• Mental Health & Wellness: Free Mental Health &Enhanced Advocacy Services
• Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.

Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.

Recruiting Vendor Disclosure Statement

Brown & Brown does not accept unsolicited resumes from external recruiters, recruitment vendors or employment agencies (“Recruiting Vendors”). Recruiting Vendors must have a valid written agreement and received prior written authorization from an authorized Brown & Brown representative before submitting candidates for any publicly posted role. Any unsolicited resumes submitted to Brown & Brown or its employees become the property of Brown & Brown, and no fees will be paid for such submissions. Additional information regarding this policy can be found on our careers page.

The Power To Be Yourself

As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.