Disability Claims Examiner jobs in Paramus, NJ

Position Overview

• Medical, Dental, Vision Benefits
• Competitive Compensation
• 401K eligible upon 1st day of employment
• Career advancement opportunities in an expanding company

• Responsible for investigation, and management of workers’ compensation claims in multiple jurisdictions.  This will include medical management and litigation management to drive claims to closure while working to actively mitigate exposure for the Company.  
• This position will coordinate between nurse case managers, counsel, external vendors, and insureds to ensure efficient and proactive claims handling.  
• Reports directly to the Director of Risk & Claims   
• This is a full-time and hybrid position (two days per week in the office)   
• Minimal in-person visits to insureds may be required.
• Responsible for completing and documenting initial loss investigations to determine compensability. 
• Establish initial and subsequent reserves to ensure reserves are adequate for anticipated exposure.
• Review medical bills for a causal relationship to reported claim. 
• Liaison with insureds, nurse case managers, and counsel to oversee management of claims and bring them to closure and facilitate full or transitional duty return to work. 
• Develop and maintain action plans to ensure reserve adequacy and bring claims to a timely resolution. 
• Negotiate settlement of claims within designated authority.
• Prepare and present claim review summaries for insureds, brokers, and internal contacts as requested. 
• Participate in roundtable discussions with the insured and counsel on strategies for successful claim closure/resolutions. 

• Demonstrates accuracy, attention to detail, and thoroughness.
• Works effectively in a fast-paced environment while providing a high level of customer service.
• Ability to work independently on assigned tasks as well as accept direction on given assignments. 
• Minimum of 5 years' experience adjusting worker's compensation claims in multiple jurisdictions. 
• Effective organizational skills.
• Proficiency in Internet software and Microsoft Products such as Word, Excel, Outlook, and internet software. 

Pay Range