Entry-Level Workers' Compensation Enhanced Medical Only Representative

. Handle first-party, medical-only workers' compensation claims .

Posted 10/15/2026full-timeNew Hartford • New York • United StatesEntry Level💰 $46,000 - $59,000 per yearWebsite

Key responsibilities & impact

Handle first-party, medical-only workers' compensation claims
Receive claims assignments consisting of insured and claimant accident reports
Adjust, negotiate, and settle justified claims within authorization or supervisor direction
Determine extent of injury, coverage questions, and medical values through investigation and evaluation
Correspond by telephone and in writing with injured workers, insureds, agents, vendors, team members, and defense counsel
Review incoming loss notices and assign them to claim representatives or the appropriate handling office/region
Take recorded statements as directed by the supervisor for compensability or third-party investigations
Handle and assign hearing notices to defense counsel
Bring claim files to closure
Set medical, other, and legal incurred when appropriate
Review medical reports, prior authorizations, bills, invoices, and other claim information to ensure payment for appropriate injury sites
Review claim practices, policy coverages, procedures, and bulletins
Attend company training classes
Perform other duties assigned by management in relation to daily operations
Conform with corporate policies and procedures

What you’ll need

Bachelor's Degree preferred or equivalent experience
2-4 years previous claims experience preferred but not required
Required to obtain adjuster license(s) in the state(s) in which assigned to adjust claims
Licensing must be obtained within the timeframe set forth by the Company and maintained as needed throughout employment
Skills in investigation, evaluation, and negotiation
Written and verbal communication skills
Ability to operate within a rules-based environment with strong customer satisfaction emphasis
Ability to adhere to mandated state regulations and corporate policies and procedures

Comp & perks

Medical and Prescription Drug Benefit
Dental Benefit
Vision Benefit
Life Insurance and Disability Benefits
401(k) Profit Sharing and Investment Plan, including annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results
Health Savings Account (HSA)
Flexible Spending Accounts
Tuition Assistance, Training, and Professional Designations
Company-Paid Family Leave
Adoption/Surrogacy Assistance Benefit
Voluntary Benefits: Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal, ID Theft Protection, Pet Insurance
Student Loan Refinancing Services
Care.com Membership with Back-up Care, Senior Solutions
Business Travel Accident Insurance
Matching Gifts program
Paid Volunteer Day
Employee Referral Award Program
Wellness programs
Personal insurance discount
Career advancement and challenging work opportunities
Full-time hourly, non-exempt position; overtime eligible