Workers Compensation 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 …