Claims Adjuster II

Job not on LinkedIn

🕒 February 17

🗽 New York – Remote

🗽 New York – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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Amynta Group

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2018

🤝 B2B

👥 B2C

Insurance • B2B • B2C

Amynta Group is a company that specializes in providing comprehensive risk management solutions, including specialty property and casualty insurance products, captive insurance programs, and warranty and protection plans. Serving both businesses and consumers, Amynta Group connects clients with a network of trusted professionals to help manage risks and achieve their goals in today's challenging environment. They represent a variety of stakeholders, including insurance companies, retail agents, auto dealers, and consumer retailers, while offering products like workers' compensation, general liability, and trade credit insurance.

📋 Description

• 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 • Authorize medical treatment based on protocols established by NYS WC law • Assist Underwriting on new and renewal business

🎯 Requirements

• Claims Adjusters License required • Bachelor's degree, or four or more years of equivalent work experience • At least 3 or more years’ experience handling New York State lost time workers compensation construction claims for Associate in Claims (AIC) Designation or similar professional designation desired • Familiarity with medical terminology • Strong organizational skills and ability to manage multiple tasks simultaneously • Demonstrated ability to work independently and with a team • Ability to analyze data and make sound decisions • Strong Knowledge of OSHA construction standards • Knowledge of NYS labor Law §240 • Computer literacy, including working knowledge of MS Office products including Word, Excel and PowerPoint • Knowledge of Claim Center a plus • Ability to travel for business purposes, less than 15%

🏖️ Benefits

• Health insurance • 401(k) matching