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.

• 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.

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New Haven, CT
onsite
Temporary
30.00 - 34.00 USD / Hourly
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.
2025-11-18T15:24:00Z

Claims Examiner-lost Time Job in New Haven | Robert Half