Dedicated Account Workers' Compensation Adjuster (NY Claims)

About the role

This is not a high-volume, multi-jurisdiction desk. This role offers the opportunity to focus exclusively on New York Workers' Compensation claims within a dedicated client account supported by a highly collaborative team.

Responsibilities

• Investigate, evaluate, and adjust Workers' Compensation claims in accordance with New York Workers' Compensation laws, regulations, and CCMSI claim handling standards.
• Develop and execute strategic action plans for complex claims.
• Evaluate medical, legal, vocational, and miscellaneous expenses for appropriateness and claim relevance.
• Negotiate settlements in accordance with client instructions, corporate standards, and applicable state regulations.
• Identify and pursue subrogation and recovery opportunities.
• Maintain proactive diary management and timely claim documentation.
• Prepare claim status reports, reserve analyses, and client communications.
• Compute disability benefits in accordance with New York Workers' Compensation requirements.
• Communicate effectively with clients, injured workers, employers, medical providers, attorneys, and other claim stakeholders.
• Participate in hearings, mediations, settlement conferences, and other claim-related proceedings as appropriate.
• Deliver exceptional client service while maintaining compliance with corporate claim handling standards and client-specific requirements.

Requirements

• Minimum of five years of Workers' Compensation claims adjusting experience.
• Active New York Workers' Compensation Adjuster's License.
• Demonstrated experience handling New York lost-time and complex Workers' Compensation claims.
• Strong working knowledge of New York Workers' Compensation statutes, regulations, and claim procedures.
• Excellent investigation, negotiation, and analytical skills.
• Ability to independently manage a full claim caseload and drive claims to resolution.
• Proficiency with Microsoft Office products, including Word, Excel, and Outlook.

Qualifications

• Prior TPA experience.
• Experience handling litigated New York Workers' Compensation claims.
• Bilingual (Spanish) proficiency—highly valued for communicating with claimants, employers, providers, and vendors but this is NOT required.

Benefits

Comprehensive benefits : Medical, Dental, Vision, Life, and Disability Insurance
Retirement plans : 401(k) and Employee Stock Ownership Plan (ESOP)
Career growth : Internal training and advancement opportunities
Culture : A supportive, team-based work environment

Pay

The posted salary reflects CCMSI’s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity.

Schedule

8:00 am-4:30 pm ET