ClaimsAdjusterII

We’re thrilled that you are interested in joining us here at the Amynta Group! As a member of Oryx Insurance Brokerage, Inc claims team, utilize knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex construction nature in order to achieve appropriate outcomes. In this position you will administer and resolve Workers Compensation claims in a timely manner in accordance with legal statues, policy provisions and carrier guidelines. ****Responsibilities:**** * Promptly investigate all assigned claims with minimal supervision, including those of a more complex Construction nature. * Determine coverage, compensability, potential for subrogation recovery, and other offsets (when applicable). * Alert Supervisor and carriers Special Investigations Unit to potentially suspect claims. * Ensure timely denial or payment of benefits in accordance with jurisdictional requirements. * Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure. * Negotiate claims settlements with carriers approval. * Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition. * Work collaboratively with medical professionals to develop and execute return to work strategies. * Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome. * Maintain a working knowledge of New York State requirements and applicable case law for NY. * Demonstrate technical proficiency through timely, consistent execution of best claim practices. * Communicate effectively, verbally and in writing, with internal and external parties on a wide variety of claims and account issues. * Provide a high degree of customer service to clients, including but not limited to day to day interactions, claims reviews and renewal meetings.