Skip to content

TPA Claims Specialist II

Location:

NY - Buffalo, NY - Glens Falls, NY - Rochester, NY - Syracuse

Apply now Share Share TPA Claims Specialist II with Facebook Share TPA Claims Specialist II with LinkedIn Share TPA Claims Specialist II with Twitter Share TPA Claims Specialist II with a friend via e-mail

Why USI?

USI is one of the largest insurance brokerage and consulting firms in the world. Something special is happening here with our more than 8,000 associates across the U.S. and abroad – and we invite you to learn more.

Unrivaled Resources and Support

The USI ONE Advantage® allows USI to deliver unique solutions to our clients. This value proposition provides unmatched growth and opportunity for our associates and, at its core, represents a significant investment in our people.

Unique Employee Programs and Deep Community Engagement

We turn care into action with our award-winning wellness program, college scholarships for associates' children, and financial help in times of need. Our annual community service initiative engages associates in hands-on regional service projects helping hundreds of thousands of people each year.

Industry-Leading Associate Rewards and Recognition

In addition to competitive pay, incentives, and benefits, USI recognizes associates through our Summit Awards program, rewarding excellence in those who build our brand each day.

Committed to a Diverse and Inclusive Work Environment  
USI values diversity and is dedicated to ensuring a fair, diverse, and inclusive work environment for all. Our diversity and inclusion program, "I'm With U," advances these initiatives to champion our team members and the communities we serve.

Nationally Recognized as a Top Insurance Workplace

USI has been recognized as one of:

·        Insurance Business America’s Top Insurance Workplaces, three years in a row (2018-2020).

·        Business Insurance’s 2020 list of Best Places to Work in Insurance.

·        Forbes Best Large Employers in America (2018-2019).

Ranked as one of Forbes Best Large Employers in America (2018-2019).

General Description: Adjuster of lost and non-lost time claims for workers compensation.


Responsibilities:

  • Advanced Knowledge of claims function and processes.
  • Ability to effectively communicate with internal and external customers.
  • Strong understanding of workers compensation or disability claims management, strategies, resolution techniques and adjusting.
  • Technical capability to enter first reports of injury and to adjust lost time and non-lost time claims utilizing the features of the TPA claim management systems.
  • Participates in claim advocacy and negotiations, including claim denials, reserving files, and claim reporting, issuing payments, attending hearings, conciliations or mediations, and filing of state forms.
  • Determine compensability of the claim as it relates to the worker compensation jurisdiction.
  • Review and approval of loss time, medical services, and expenses to be paid of the claims file.
  • Plan and attend claim reviews with clients, carriers, and auditors.
  • Ability to identify client issues, build a plan towards resolution, execute, and manage internal and external expectations effectively.
  • Analyzes claims based on the TPA best practices as outlined in the "Policy and Procedures" manual.


Knowledge, Skills and Abilities:

  • Ideal candidate will have a minimum 5 years of claims adjusting experience.
  • College degree preferred but high school diploma or graduate equivalent degree required.
  • Proficient-to-expert in MS Office suite of products.
  • Must be licensed in all jurisdictions handled.
  • Superior written and oral communication skills.
  • Ability to work well in a team environment.
  • Must have strong analytical thinking and problem-solving skills.
  • Strong organizational skills required.
  • Strong negotiation skills required.
  • Bilingual (Spanish) skills are a plus

USI is committed to providing a full-suite of competitive benefits for our growing population and its diverse needs. We offer a wide range of health, welfare and financial benefits including medical, wellness, dental and vision, 401(k), flexible spending and health savings accounts, short and long-term disability, life insurance and other unique employer-sponsored and voluntary programs. USI also offers a generous paid time off policy, paid family leave benefit as well as paid holiday time.


Job ID:

22353

Interested in hearing about other USI Career Opportunities?

Join Our Talent Network
EEO is The Law - click here for more information
Notice to 3rd Party Recruiters

Notice to Recruiters and Agencies regarding unsolicited resumes or candidate submissions without prior express written approval.
Resumes submitted or candidates referred to USI Insurance Services by any external recruiter or recruitment agency by any means (including but not limited to via Internet, e-mail, fax, U.S. mail and/or verbal communications) without a properly executed written contract for a specified position by an authorized member of the Talent Acquisition team become the property of USI Insurance Services. The Company will not be responsible for, or owe any fees associated with, referrals of those candidates and/or for submission of any information, including resumes, associated with individuals.

We endeavor to make this site accessible to any and all users. If you would like to contact us, please email recruiting@usi.com