Technical Claims Director

A top-rated insurance carrier is seeking to add a Technical Claims Examiner. The ideal candidate will be responsible for managing an assigned pending of Complex New York Labor Law claims and operate under appropriate levels of supervision and within established authority.

Salary ($160,000.00 to $180,000.00)

Job Responsibilities

• Verifies and determines applicability of coverage for New York Labor Law claims.
• Investigate coverage issues and prepare ROR’s and denial letters.
• Evaluates and manages litigated claims, handle million dollar plus losses
• Consults with the claim manager on those claims in which assistance and consultation is needed, as well as on those claims which exceed assigned authority.
• Keep the client and the insured informed about the claim status with clear, timely and accurate written/oral communication.
• Ability to negotiate settlement of claims of varying complexity under the general direction of the Claims Manager.

Qualifications

Business Acumen and Technical Expertise

Possess superior analytical and critical thinking skills, expert knowledge of complex medical terms, excellent time management abilities

Possess the advanced technical knowledge to properly reserve highly complex New York Labor claims

Technical expertise in managing claims of high complexity

Strong computer proficiency in utilizing software programs

Excellent communication skills, oral, written, collaboration and negotiation

Benefits

Lucrative Profit sharing plan

Sign on Bonus, Plus Yearly Bonus

401(k) with competitive company matching

Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)

Company paid group term life, short- term disability and long-term disability coverage