PPD Claim Associate

Title: PPD Claims Associate Rate of Pay: Commensurate with experience FLSA Status: Non-Exempt Employer: Joint Industry Board of the Electrical Industry Department: EESISP Reports to: EESISP Supervisors Location: Flushing, NY 11365 JOB DESCRIPTION Reporting to the EESISP Supervisors, under close direction and oversight, the PPD Claims Associate will perform various duties including but not limited to: PPD Examiner duties include: Regular review of all resolved classified PPD cases both pre-cap and post-cap for settlement Negotiation of Section 32 settlements with attorneys, subject to approval by SupervisionProvide status reports to Excess carrier on all previously classified cases requiring updatesScheduling annual (semi-annual) alive and well checks on all classified cases, and necessary follow ups including surveillance in appropriate casesResponsible for maintenance of adequate reserves on all classified cases Provide status reports to Senior Management on any and all cases on an as-needed basis Process payments utilizing software system on select cases Communicates with Excess carrier on cases where it appliesCommunicate with the members on various issues that may occurMay schedule an IME if needed to review need for treatmentOccasionally authorize medications for treatmentPerforms other duties and special assignments as deemed necessary Serve as back up for active claims, in this capacity the Examiner will be responsible for the following duties: Review of electrical industry workers compensation claims and determine compensability File all required workers compensation forms timely Oversee medical management and investigations of claimsCalculate payroll and compensation payment based on set guidelinesServe as liaison and interface with Magna Comp nurse and claimant as part of the review processAssign cases for investigations and review progressPrepare workers compensation claim for long-term disabilityAbility to evaluate the degree of disability and scheduled loss value Maintains professional relationship with all appropriate parties involved with the claim.Refers cases as appropriate to management. Actively executes appropriate claims activities to ensure consistent delivery of quality claims service.Develops and manages claims through well-developed action plans, continues to monitor and work the action plan to timely and appropriate resolutionAnalyze and processes workers compensation claims by investigating, research, and gathering information to determine the exposure on the claimPerform other duties and special assignments as necessary Work Environment This job operates in a professional office -- customer service environment. This role routinely uses standard office equipment such as desktop computers, phone, scanner, printer, keyboard, photocopiers, shredder and fax. Physical Demands Sedentary work environment with physical demands described are representative of those that must be met by an employee to successfully perform the functions of this job. This would require the ability to lift files, pull files/forms/books, stand, bending, shred documents, open/close filing cabinets as necessary. Position Type/Expected Hours of Work This is a full-time onsite 35 hours per week Non-Exempt position. Days and hours of work are Monday through Friday 8:30AM-4:30PM. Flexibility: Must be able to work overtime when necessary. Travel - No travel is expected for this position.