Job Description

About the Opportunity: Our client, a leading Third-Party Administrator (TPA), is seeking an experienced Workers’ Compensation Claims Adjuster to join their growing team. This role is responsible for managing a caseload of New York workers’ compensation claims from inception through resolution while ensuring compliance with all state regulations. Compensation & Benefits:

• $80,000 - $95,000/year (based on years of experience)
• Performance-based bonus opportunities
• Comprehensive benefits package (medical, dental, vision)
• 401(k) with company match
• Flexible remote work environment

Qualifications:

• Active New York Adjuster’s License (Required)
• 3+ years of experience handling NY Workers’ Compensation claims
• Strong knowledge of New York jurisdiction, regulations, and compliance requirements
• Experience working within a TPA or insurance carrier environment
• Excellent organizational, analytical, and negotiation skills
• Ability to manage a high-volume caseload in a fast-paced environment
• Strong written and verbal communication skills

Key Responsibilities:

• Manage a full caseload of New York Workers’ Compensation claims with varying levels of complexity
• Conduct thorough investigations, including reviewing medical records, accident reports, and witness statements
• Evaluate compensability and establish appropriate reserves
• Maintain proactive communication with claimants, employers, attorneys, and medical providers
• Ensure timely and accurate claim handling in accordance with New York Workers’ Compensation laws and guidelines
• Coordinate with defense counsel and attend hearings as needed
• Negotiate settlements and bring claims to timely resolution
• Maintain detailed and accurate claim documentation

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