Claims Specialist I - Worker's Compensation

Utica National Insurance Group Woodbury, NY
If you seek a truly outstanding employment experience, Utica National is the place for you. We are always looking for conscientious, customer-oriented people - whether you're a seasoned insurance professional or just starting out. We offer a supportive and friendly work environment that features a variety of career paths.

We offer challenging assignments, advancement opportunities, full benefits packages, competitive salaries, and a great work environment. We're big enough to offer the opportunities you need to be successful, but not so big that you'll get lost in the crowd.

Responsible for:

Delivering best-in-class claims service in an efficient and compassionate manner, and with an uncompromising focus on our customers.


1. Adjust Workers Compensation claims.

2. Communicate directly with insureds, claimants, witnesses, attorneys, medical providers and others, by telephone and through written correspondence. Correspond with Home Office and other field adjusters. Document investigation in Utica's claim system.

3. Conduct timely investigations, interview individuals, secure recorded and signed statements, check and verify damages, wage statements, medical reports and bills, photographs, diagrams, and other information pertinent to the investigation.

4. Review and analyze insurance policies and endorsements on less complicated matters to determine if coverage is afforded. Send basic Reservation of Rights letters involving questionable coverage and Disclaimer letters for no coverage claims where appropriate.

5. Evaluate exposure and set and adjust monetary incurreds to reflect most likely outcome within requisite authority level.

6. Determine liability, review injury and treatment information, evaluate all documentation and prepare claim for settlement evaluation.

7. Negotiate and settle justified claims for the proper amount supported by the investigation. Secure releases and/or proofs of loss, issue settlement check or deny unjustified claims.

8. Maintain claim file diaries that promote timely investigation and file resolution.

9. Identify and pursue all subrogation opportunities and involve SIU in any claim where fraud is suspected.

10. Review, study and adhere to Utica's claim handling practices, policy coverages, procedures, bulletins, court decisions and attend company sponsored training.

11. Comply with all applicable state Insurance Department regulations.

12. Obtain and/or maintain state license(s) or certification(s) as needed.

13. Consult with supervisor on claims involving questionable liability, coverage issues, evaluation of damages and settlements exceeding authority. Adhere to directives and instruction from supervisor and superiors.


Four year degree or equivalent experience preferred.


1-3 years Insurance claims experience preferred.


We believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. We offer a Comprehensive Benefits Plan for full time employees that include the following:

* 401K plan

* Medical coverage

* Dental coverage

* Flexible spending accounts

* Vision care coverage

* Paid Time-Off (PTO)

* Paid Holidays

* Paid Volunteer Day

* Pay-for-Performance

* Employee and Dependent life insurance

* Disability insurance

* Accidental death & dismemberment insurance

* Discounts on automobile and homeowner's insurance

* Tuition reimbursement

* Employee Assistance Program (EAP)

* Credit Union membership

* Employees' Club


We offer both full and part time employment with the goal of providing work life balance to our talented workforce.

As part of our hiring process, candidates must also pass a comprehensive background check and drug screen, additional screening for credit or MVR may be required for some positions.

Utica National is an Equal Opportunity Employer.

Apply now and find out what it's like to be a part of an amazing team, thrive in an exciting environment and work for a company you can be proud of. Once you complete your application, you can monitor your status in the hiring process by logging into your profile. A representative from our Talent Management Group will be in touch if you are moving forward. Candidates must meet company requirements on our online assessment test.