Claims Consultant

Managed Care Network, Inc., (MCN) is a growing company headquartered in Niagara Falls, New York, which offers claim administration support services to Property & Casualty Insurance Carriers throughout New York State.

MCN strives to be the best in the P&C marketplace by providing our customers with responsive service, innovative solutions, and high-quality outcomes. We take pride in our work and our company, and for being viewed as a reliable and dependable partner to our customers. We value our customers each and every day and in everything we do.

POSITION SUMMARY:

The Claims Liaison at Managed Care Network will be responsible for overseeing the Claims Department in its role of assisting customers in performing best practices of resolving NYS Workers’ Compensation Claims.

The ideal candidate should possess a deep understanding of NYS-specific workers’ compensation claims processing and be well-versed in all aspects of the litigation of a claim. The ideal fit will possess strong skills in the following: (i) WC claim processes and requirements, (ii) be versed in negotiating Section 32 settlements, (iii) setting reserves and drafting reserve rationales, (iv) review of medical records and (v) understanding all considerations factored in a loss of wage-earning capacity and indemnity reserves. (vi) strategies for claim resolutions on complex claims.

This unique role will consist of working in a team environment with other highly skilled professionals on every claim as the expert in Workers Compensation claim processes and requirements.

Essential Functions of the Position Include:

Technical:

· Expertise in NYS workers' compensation claims administration.

· Conduct performance reviews for claims staff.

· Exhibit problem-solving skills by employing creative and innovative approaches.

· Manage diaries of claims staff and ensure timely follow-ups.

· Review and provide feedback on team reports and work-product.

· Experience and the ability to perform customer interfacing

· Point of contact for client interface for the Claims Department.

· Possess strong business acumen.

· Address inquiries from staff and clients promptly and efficiently.

· Must have the ability to think outside of the box and have creative problem-solving abilities while stringently following rules and regulations.

Qualifications:

· Bachelor's or Law degree (preferred).

· Extensive experience in New York Workers' Compensation claims management.

· Prior experience in managing a claims team is a plus.

· Experience in or desire to learn the business side of handling claims.

· Excellent communication and interpersonal skills.

· Must be a team player and capable of working in a team setting.

· Strong analytical and problem-solving skills.

Job Type: Full-time

Pay: $80,000.00 - $120,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Hybrid work
• Office

Ability to Relocate:

• Niagara Falls, NY 14303: Relocate before starting work (Required)

Work Location: Hybrid remote in Niagara Falls, NY 14303