Job Posting

Job Opening Information CLAIMS ADMINISTRATOR / EXAMINER (Workers' Comp.), Full-time position, 12 months/yr.

Job Number
Admin/CS-11/19/21
Application Deadline
12/13/2021

Position Title
CLAIMS ADMINISTRATOR / EXAMINER (Workers' Comp.), Full-time position, 12 months/yr.
Required Application Type
School Related Personnel
Salary/Pay Scale
According to Board Approved rate
Job Description

Responsible for the administration of all aspects of a self-funded workers’ compensation plan. Analyzes complex or technically difficult claims to determine benefits due; works with high exposure claims involving litigation and rehabilitation; ensures ongoing adjudication of claims within service expectations, industry best practices and specific district service requirements; and identifies subrogation of claims and negotiate settlements.

Essential Duties:

  1. Analyzes and manages complex or technically difficult claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
  1. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
  1. Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
  1. Prepares necessary state fillings within statutory limits.
  1. Coordinates vendor referrals for additional investigation and/or litigation management.
  1. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
  1. Manages claim recoveries, including but not limited to subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
  1. Maintains all records of employees receiving workers' compensation;
  1. Completes and reviews forms supporting medical statements from employees related to workers' compensation to insure compliance with the State Workers' Compensation Laws;
  1. Completes statistical forms and reports required along with a monthly accident report mandated by the State;
  1. Assists in inspections and investigations to identify and correct potential problems in work procedures and promote employee safety;
  1. Examines workers' compensation claims and processes all eligible medical and indemnity claims; Manages the workers' compensation claims office;
  1. Communicates with employers, claimants, medical providers, attorneys, consultants, and the New York State Workers' Compensation Board, as required;
  1. Represents the employer in negotiations concerning claims.
  1. Other duties as assigned by the Workers' Compensation Claims Supervisor.
Civil Service Title
Claims Administrator (Competitive)
Job Qualifications

*Monroe County Residency is required

Must possess or meet requirements for Civil Service title of Claims Administrator. 

MINIMUM QUALIFICATIONS:  Graduation from high school or possession of an equivalency diploma plus EITHER:

(A)        Graduation from a regionally accredited or New York State registered college or university with an Associate's degree, plus two (2) years paid full-time or its part-time equivalent  experience in processing workers' compensation claims, or liability and casualty insurance policies; OR,

(B)       Four (4) years paid full-time or its part-time equivalent experience as    defined in (A) above.

Application Procedure

Please apply online at: https://monroe2boces.recruitfront.com/Account/Login

Please refer to above Required Application Type to complete before applying.

Job Category
Clerical
Job Location
District Wide

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