Abrar Admin

Highview National Insurance Company

Worker&rsquo;s compensation insurance is a headache.We make it simple, smooth, and stress free.Join us in redefining workers&rsquo; comp. Job Summary:The Claims Assistant will provide vital administrative support in processing and managing insurance claims. This role involves organizing claim-related documents, communicating with clients and insurance companies, and ensuring the accuracy and completeness of claim information. Your work ensures that claims move efficiently, helping both businesses and injured workers navigate the process with ease.Essential Job Functions:<ul><li>Organizes and maintains claim-related documents and records.</li><li>Inputs and updates claim information accurately in databases or software systems.</li><li>Communicates with clients, insurance companies, and other relevant parties to gather necessary claim details.</li><li>Prepares and submits claim forms and documentation to insurance companies within specified deadlines.</li><li>Follows up on outstanding claims and obtains additional information as needed for claims processing.</li><li>Provides administrative support to claims adjusters or managers, including scheduling appointments and managing correspondence.</li><li>Provides Claims Information to insurers including billing information and adjuster contact.</li><li>Ensures confidentiality of sensitive claim information following privacy regulations.</li><li>Assists in preparing reports and presentations related to claim processing and management.</li><li>Performs other duties as assigned.</li></ul>Required Skills/Abilities:<ul><li>Ability to exemplify the Highview National core values such as Collaboration, Excellence, Integrity, and Responsiveness.</li><li>Ability to maintain confidentiality of conversations, data records, files, and other vital information.</li><li>Preferred candidate is bright, trainable, and looking for a career (not just a job).</li><li>Strong attention to detail and takes initiative &ndash; not afraid to ask questions.</li><li>Computer literacy - comfortable using Microsoft Office Suite including Word, Excel, and Outlook.</li><li>Excellent communication skills - able to write professional emails and speak with confidence and clarity.</li><li>Strong problem-solving skills and ability to handle stressful situations with professionalism.</li></ul>Education and Experience:<ul><li>High school diploma or equivalent (Seminary graduates welcome)</li><li>Previous experience in administrative or clerical roles is advantageous.</li><li>1 year of experience with insurance industry practices and claim processing procedures is a plus but not required.</li></ul>Physical Requirements:<ul><li>Prolonged periods sitting at a desk and working on a computer.</li><li>Prolonged periods of standing, walking, and/or sitting and reaching with hands and arms.</li><li>Must be able to lift 10 pounds at a time.</li></ul>Additional Requirements:<ul><li>Due to the nature of our business, and urgency of our clients' needs, you may be required to participate in the Company&rsquo;s on call program and work on holidays/weekends according to the on-call schedule.</li></ul>Additional Job Details:<ul><li>Scope of employment: Full-time, potential &frac12; day on Fridays</li><li>Location: Monsey area</li><li>Salary: $25-30/hour</li></ul>We are an Equal Opportunity EmployerWe do not discriminate based on race, color, religion, national origin, sex, age, disability, genetic information, or any other status protected by law or regulation. We intend that all qualified applicants are given equal opportunity and that selection decisions be based on job-related factors.Job Type: Full-timePay: $25.00 - $30.00 per hourBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Ability to Commute:<ul><li>Suffern, NY 10901 (Required)</li></ul>Work Location: Hybrid remote in Suffern, NY 10901

Workers' Compensation Claims Assistant

Worker&rsquo;s compensation insurance is a headache.We make it simple, smooth, and stress free.Join us in redefining workers&rsquo; comp.Job Summary:The Workers&rsquo; Compensation Claims Examiner is responsible for the investigation, evaluation, and management of lost time workers&rsquo; compensation claims. This role involves overseeing medical and litigation management to drive timely claim resolutions while actively mitigating risk and financial exposure for the company. This document serves as a Guideline and your activities should not limited to only these activities.The Claims Examiner will collaborate with nurse case managers, legal counsel, external vendors, and insureds to ensure efficient, proactive claims handling. This position requires strong analytical skills, adaptability, and the ability to navigate evolving workers&rsquo; compensation laws and processes effectively.Essential Job Functions:<ul><li>Conduct and document thorough loss investigations to determine compensability.</li><li>Establish and adjust reserves to align with anticipated exposure.</li><li>Review medical bills to confirm causal relationship to claims.</li><li>Collaborate with insureds, nurse case managers, and legal counsel to facilitate claim resolution and return-to-work processes.</li><li>Develop action plans to maintain reserve adequacy and ensure timely settlements.</li><li>Negotiate claim settlements within designated authority.</li><li>Prepare and present claim review summaries to stakeholders.</li><li>Participate in strategy discussions to drive successful claim outcomes.</li><li>Guide insureds and brokers on timely claim reporting and best practices.</li><li>Oversee insured onboarding and training for claims reporting and portal use.</li></ul>Required Skills/Abilities:<ul><li>Excellent oral and written communication skills&mdash;able to convey complex information effectively.</li><li>Detail-oriented with a high accuracy rate, ensuring precision in claim processing.</li><li>Strong critical thinking and problem-solving skills to assess claims efficiently and make informed decisions.</li><li>Flexible and tech-savvy, comfortable navigating various software tools and adapting to new processes.</li><li>Highly adaptable, able to adjust to evolving laws and industry changes with ease.</li><li>Thrives in a dynamic environment&mdash;willing to embrace change and contribute to continuous improvement.</li><li>Self-motivated with excellent time management, capable of handling multiple priorities effectively.</li></ul>Education and Experience:<ul><li>Bachelor&rsquo;s degree preferred</li><li>Professional designation such as AIC or CPCU preferred</li><li>Examiner license required</li><li>5-7 years adjusting lost time worker&rsquo;s compensation claims</li><li>NY experience required.</li></ul>Physical Requirements:Prolonged periods sitting at a desk and working on a computer.<ul><li>Prolonged periods of standing, walking, and/or sitting and reaching with hands and arms.</li><li>Must be able to lift 10 pounds at a time.</li><li>Additional Requirements:</li><li>Due to the nature of our business, and urgency of our clients' needs, you may be required to participate in the Company&rsquo;s on call program and work on holidays/weekends according to the on-call schedule.</li></ul>We are an Equal Opportunity EmployerWe do not discriminate based on race, color, religion, national origin, sex, age, disability, genetic information, or any other status protected by law or regulation. We intend that all qualified applicants are given equal opportunity and that selection decisions be based on job-related factors.Job Type: Full-timePay: $80,000.00 - $115,000.00 per yearBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>People with a criminal record are encouraged to applyWork Location: Hybrid remote in Suffern, NY 10901

PA Lost Time WC Claims Examiner

Join Highview National Insurance Company and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Highview National Insurance Company

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Workers' Compensation Claims Assistant

PA Lost Time WC Claims Examiner