WC Claims Adjuster

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

Wright Public Entity serves as a management company providing claims administration, risk management & loss control, underwriting & marketing, and client services in New York. We also act as a TPA for Workers Compensation for various self-insured schools & municipalities in New York.

The Adjuster position will manage Workers’ Compensation claims within specific limits and authority.

Responsibilities:

• 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 set 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.

Position Requirements:

• Exceptional telephone demeanor.

• Ability to maintain a high level of confidentiality.

• Prior experience in adjusting New York State workers’ compensation claims.

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

• Planning/organizing—the individual prioritizes and plans work activities and uses time efficiently.

• Interpersonal skills—the individual maintains confidentiality, remains open to others' ideas and exhibits willingness to try new things.

• Oral communication—the individual speaks clearly and persuasively in positive or negative situations and demonstrates group presentation skills.

• Written communication—the individual edits work for spelling and grammar, presents numerical data effectively and can read and interpret written information.

• Problem solving—the individual identifies and resolves problems in a timely manner, gathers and analyzes information skillfully and maintains confidentiality. 

• Quality control—the individual demonstrates accuracy and thoroughness and monitors own work to ensure quality.

• Adaptability—the individual adapts to changes in the work environment, manages competing demands and can deal with frequent change, delays or unexpected events.

• Safety and security—the individual observes safety and security procedures and uses equipment and materials properly.

What We Offer

• Excellent growth and advancement opportunities

• Competitive pay based on experience

• Ability to work remotely

• Paid Time Off

• Generous benefits package: health, dental, vision, 401(k), and many additional benefits

• Employee Stock Purchase Plan

• Salary Range: $80,000 - $90,000

Pay Range

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. 

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”.