Claims Examiner-Lost Time

Robert Half • New Haven, CT • 5h ago

Description We are looking for a skilled Claims Examiner specializing in lost time workers' compensation claims to join our team in Jersey City, New Jersey. This is a contract position requiring expertise in managing claims processes from initiation to resolution. The role involves handling complex cases, ensuring compliance with statutory regulations, and delivering exceptional customer service.

Responsibilities:

Manage the full lifecycle of workers' compensation lost time claims, from initial setup to closure, ensuring a seamless process.

Conduct detailed investigations, including gathering facts, taking statements, and reviewing policy details to assess claim validity.

Evaluate claim compensability based on investigation findings and communicate decisions to claimants, insured parties, and attorneys.

Prepare comprehensive reports on claim statuses, settlements, denials, and evaluations of involved parties.

Administer statutory medical and indemnity benefits promptly throughout the duration of the claim.

Set and adjust reserves for medical, indemnity, and expenses within established authority limits.

Collaborate with attorneys to manage hearings and litigation effectively.

Oversee vendors, rehabilitation managers, and case managers to support medical management and return-to-work initiatives.

Ensure compliance with state regulations by filing necessary workers' compensation forms and electronic data.

Identify subrogation opportunities and secure required information to maximize recovery potential. Requirements - Minimum of 3 years of experience as a Lost Time Claims Examiner or equivalent expertise in related fields such as paralegal work, disability claims, or personal injury protection.

Strong knowledge of workers' compensation statutes, regulations, and compliance requirements.

Proficiency in claims administration, data analytics, and modeling to enhance decision-making processes.

Excellent communication and customer service skills to manage interactions with claimants, attorneys, and medical providers.

Ability to work collaboratively with internal teams, including technical assistants, investigators, and case managers.

Experience with Microsoft Office Suite and other tools essential for claims management.

Exceptional time management skills to prioritize tasks and meet deadlines.

Familiarity with litigation processes and managing hearings effectively. TalentMatch®

Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.

All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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