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TI

Workers' compensation Subrogation Examiner

Tristar Insurance
🇺🇸 United States
Remote
3 months ago
$29.00 – $31.25 / hour
  • 10-key
  • Excel
  • PowerPoint
3 months ago
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POSITION SUMMARY:Perform Workers Compensation, subrogation and recovery tasks within the claims handling guidelines and in accordance with established Best Practices.

 

DUTIES ANDRESPONSIBILITIES:

 

  • Identify subrogation opportunities through review of loss information and FNOLdata.
  • Place carriers on notice ofsubrogation
  • Perfect the lien and manage contact with claimants and their legalrepresentatives.
  • Obtain documents supporting subrogation fromclients.
  • Submit demands forsubrogation.
  • Affect subrogationrecovery.
  • Set reserves, post recoveries, track financialelements.
  • Tasks as directed by leadership.
  • Mentor team members pursuant to subrogation best practices to enhance technical knowledge andefficiency
  • Collaborate with leadership and legal counsel on litigation, arbitration, and mediationstrategies

EQUIPMENT OPERATED/USED: Computer, 10-key, printer, copier, fax/scanner machine and other officeequipment.

SPECIAL EQUIPMENT OR CLOTHING:   Appropriate officeattire

Qualifications

QUALIFICATIONSREQUIRED:

 

  • Education/Experience: High school diploma, GED, 2 years of college or equivalent workexperience
  • 2-5 Years of Workers Compensation Subrogation RecoveryExperience
  • Multi-jurisdictional workers' compensation subrogationhandling
  • Familiarity with New York Labor Law/New York ScaffoldLaw
  • Additional experience with construction-related and complexclaims
 
  • Basic proficiency with email applications, as well as common office applications (email, Word, Excel basic,PowerPoint)

PreferredSkills:

  • Prefer candidates with auto subrogation recoveryexperience.
  • Demonstrated verbal and written communicationsskills.
  • Demonstrated advanced analytical, decision making and negotiationskills.
  • Computerproficiency.
  • Ability to communicate effectively and clearly, both orally and inwriting.
  • Ability to manage relationships in a fast-paced environment, while demonstrating problem solving and decision-making skills to work with customers.
  • Good analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions with a minimal amount of supervision.
  • Excellent customer serviceskills.
  • Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently and exhibit good common sense.
  • An ability to handle assigned claims following company guidelines and industry best practices with a minimal amount of supervision.
  • Time management skills, organizational skills, and ability to prioritize issues and tasks.
  • Ability to effectively operate computer equipment andapplications.
  • Independence, flexibility, andcreativity.

OtherQualifications:

  • None

Mental and Physical Requirements: [see separate attachment for a copy of the checklist of psychological and physical requirements]

 

MENTALANDPHYSICALREQUIREMENTS
  1. MENTALEFFORT

 

    1. Reasoningdevelopment:

 

       Followone-ortwo-stepinstructions,routine,repetitivetask.

 

X       Carryoutdetailedbutuninvolvedwrittenorverbalinstructions;dealwithafewconcrete. variables.

 

       Followwritten,verbal,ordiagrammaticinstructions,severalconcretevariables.

 

       Solvepracticalproblems;variousvariableswithlimitedstandardization;interpretinstructions.

 

       Logicalorscientificthinkingtosolveproblems,severalabstractandconcretevariables.

 

       Widerangeofintellectualandpracticalproblems;comprehendmostobscureconcepts.

b.      Mathematicaldevelopment:

 

       Simpleadditionandsubtraction;copyingfigures,counting,andrecording.

 

 

X       Add,subtract,multiply,anddividewholenumbers.

 

       Arithmeticcalculationsinvolvingfractions,decimals,andpercentages.

 

       Arithmetic,algebraic,andgeometriccalculations.

 

       Advancedmathematicalandstatisticaltechniquessuchascalculus,factoranalysis,andprobability determination.

 

       Highlycomplexmathematicalandstatisticaltechniquessuchascalculus,factoranalysis,andprobabilitydetermination require a theoretical application.

c.       Languagedevelopment:

 

       Abilitytounderstandandfollowverbalordemonstratedinstructions;writeidentifyinginformation;requestsupplies verbally or in writing.

 

X       Abilitytofile,post,andmailmaterials;copydatafromonerecordtoanother;interviewtoobtainbasicinformation such as age, occupation, and the number of children; guide people and provide primarydirection.

 

       Abilitytotranscribedictation;makeappointmentsandprocessmail;writeformlettersorroutinecorrespondence; interpret written work instructions; interview job applicants.

 

       Abilitytocomposeoriginalcorrespondence,followtechnicalmanuals,andhaveincreasedcontactwith people.

 

       Abilitytoreport,write,oreditarticlesforpublication;preparedeeds,contracts,orleases;prepareanddeliver lectures; interview, counsel, or advise people; evaluate technical data.
  1. PHYSICALEFFORT

 

    1. Physicalactivityrequiredtoperformthejob:

 

        Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of forcefrequentlyorconstantlytolift,carry,push,pull,orotherwisemoveobjects.Sedentaryworkinvolvessittingmost of the time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.

 

       Lightwork:

      1. Exertingupto20poundsofforceoccasionally
      2. Exertingupto10poundsfrequently
      3. Exertinganegligibleamountofforceconstantlytomoveobjects

 

(Iftheuseofarmand/orlegcontrolsrequiresexertionofforcesgreaterthanthatforSedentaryWorkandthe worker sits most of the time, the job is rated for Light Work).

 

X       Mediumwork:

  1. Exertingupto50poundsofforceoccasionally
  2. Exertingupto20poundsofforcefrequently
  3. Exertingupto10poundsofforceconstantlytomoveobjects

 

       Heavywork:

  1. Exertingupto100poundsofforceoccasionally
  2. Exertingupto50poundsofforcefrequently
  3. Exertingupto20poundsofforceconstantlytomoveobjects

 

       Veryheavy work:

  1. Exertinginexcessof100poundsofforceoccasionally
  2. Exertinginexcessof50poundsofforceconstantlytomoveobjects
  3. Exertinginexcessof20poundsofforceconstantlytomoveobjects

b.       Visualrequirementsnecessarytoperformthejob:

 

X         Far vision: clarity of vision at 20 feet ormore

 

X         Near vision: clarity of vision at 20 inches orless

 

X        Mid-rangevision:clarityofvisionatdistancesofmorethan20inchesandlessthan20 feet

 

        Depthperception:theabilitytojudgedistanceandspacerelationships,soastoseeobjectswhereandasthey actually are.

 

        Colorvision:abilitytoidentifyanddistinguishcolors.

 

         Field of vision: ability to observe an area up or down or to the right or left while eyes are fixed on a givenpoint.

 

2.PHYSICALEFFORT(cont.)

FREQUENCY

c. Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally):

 

  Climbing:        Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs and/or hands and arms. Body agility isemphasized.Thisfactorisimportantiftheamountandkindofclimbingrequired exceeds that required for ordinary locomotion.

 

  Balancing:      Maintainingbodyequilibriumtopreventfallingwhenwalking,standing,or crouching on narrow, slippery, or erratically moving surfaces. This factor is important if the amount and kind of balancing exceeds that needed for ordinary locomotion and maintenance of body equilibrium.

 

X Stooping:      Bendingbodydownwardandforwardbybendingspineatthewaist.

This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.

 

X Kneeling:        Bending legs at knee to come to a rest on knee orknees.

 

X Crouching:    Bendingthebodydownwardandforwardbybendinglegsandspine.

 

 

 

 

 

 

 

 

 

 

 

 

 

Regularly

 

 

Occasionally Regularly

 

 

  Crawling:

 

X Reaching:

 

X Standing:

 

X Walking:

 

 

X Pushing:

 

Moving about on hands and knees or hands and feet. Extending hand(s) and arm(s) in any direction.

Particularlyforsustainedperiodsoftime.

 

Movingaboutonfoottoaccomplishtasks,particularlyforlong distances.

 

Usingupperextremitiestoppressagainstsomethingwithsteadyforce

 

 

 

Regularly Regularly Regularly

Regularly

 

 

X Pulling:

 

 

  Foot

Motion:

 

X Lifting:

 

 

 

 

X Fingering:

 

 

X Grasping:

inordertothrustforward,downward,oroutward.

 

Using upper extremities to extent force in order to drag, haul, or tug objects in a sustained motion.

 

 

Usingfeettopushpedals.

 

Raising objects from a lower to a higher position or moving objectshorizontallyfrompositiontoposition.Thisfactorisimportantifitoccursto a considerable degree and requires substantial use of the upper extremities and back muscles.

 

Picking,pinching,typing,orotherwiseworkingwithfingersratherthanwith the whole hand or arm as in handling.

 

Applyingpressuretoanobjectwiththefingersandpalm.

 

Regularly

 

 

Regularly

 

 

Regularly

 

Regularly

 

 

2.PHYSICALEFFORT(cont.)

FREQUENCY

XTalking:            Expressing or exchanging ideas by means of the spoken word. Thoseactivitiesinwhichworkersmustconveydetailedorimportantspokeninstructions to other workers accurately, loudly, or quickly.

 

XHearing:          Perceivingthenatureofsoundswithorwithoutcorrection.Abilitytoreceive detailed information through verbal communication, and to make fine discriminations in sound, such as when making find adjustments on machined parts.

 

  Feeling:          Perceivingattributesofobjects,suchassize,shape,temperature,ortexture by touching with skin, particularly that of fingertips.

 

XRepetitive       Substantialmovements(motions)ofthewrists,hands, Motion:         and/or fingers.

Occasionally

 

 

 

Occasionally

 

 

 

 

 

 

 

Frequently

3.WORKINGCONDITIONS

 

Disagreeablejobconditionstowhichtheemployeemaybeexposedandthefrequency(e.g.,continually,
 

frequently,oroccasionally)ofthisexposure.

WORKINGCONDITION ENVIRONMENTAL FACTOR

NATURE/REASONOF EXPOSURE

 

FREQUENCY

Dirt/Dust

 

 

Noise

 

 

Temperatureextremes

 

 

Dampness

 

 

Vibrations

 

 

Equipmentmovementhazard

 

 

Chemicals/solvents

 

 

Electricalshock

 

 

Significantworkpace/pressure

 

 

Odors/Fumes

 

 

Other(specify):                                                   

 

 

 

Workers' compensation Subrogation Examiner · Tristar Insurance

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