Worker's Compensation Maintenance Claims Representative (hybrid

Worker's Compensation Maintenance Claims Representative (hybrid)

Job Category
:
Claims

Requisition Number
: WORKE
006831

• Posted :
  July 31, 2026
• Full-Time
• Hybrid

Showing 1 location

At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day:
To make people feel secure, appreciated, and respected.

Utica National Insurance Group is an  A  rated $1.6B award-winning, nationally recognized property & casualty insurance carrier.

Operating along the Eastern half of the United States, our Home Office is based in Central New York, with Regional Office locations including Buffalo, Boston, NYC, Atlanta, Dallas, Columbus, Richmond, and Chicago.

What you will do

In this role, you'll handle primarily NY workers' compensation maintenance files which involve claims that have lifetime exposures of medical treatment and/or lost time. Skills in detail orientation will be used to manage a diary, handle incoming mail, review medical bills, issues checks, and follow medical treatment guidelines. With your customer service abilities, you will also communicate directly with insureds, claimants, and medical providers.

This role will be a hybrid position reporting to New Hartford, NY;
Woodbury, Long Island; or Charlotte, NC.

Key responsibilities:

• Handle maintenance files, receiving and handling all WC claims involving lifetime exposures of lost time and/or medical treatment.
• Review medical bills, issue indemnity checks, apply medical treatment guidelines.
• Tasks include, but are not limited to: diary management, mail management, setting reserves, evaluation of compensability of treatment, annual reporting, age changes, activity checks, IME, UR, or Peer Reviews and other duties as assigned.
• Communicate directly with insureds, claimants, medical providers and others by telephone and through written correspondence.
• Occasionally settle smaller claims.
• Handle all claim assignments in accordance with quality program criteria.
• Follow directives and instructions from the Claims Supervisor.
• Performs other duties as assigned.
• Conforms with all corporate policies and procedures.

What you need:

• Bachelor's Degree preferred or equivalent experience;
  Insurance coursework is helpful.
• 2-3 years previous claims experience preferred.
• NY claims experience preferred; knowledge of other Northeastern states helpful.

Licensing:

Required to obtain your license(s) as an adjuster in the state(s) in which you are assigned to adjust claims. Licensing must be obtained within the timeframe set forth by the Company and must be maintained as needed throughout your employment.

Salary range: $44,000 - $55,000

The final salary to be paid and position within the internal salary range is reflective of the employee’s work experience, their geographic location, education, certification(s), scope and responsibilities in the role, and additional qualifications.

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:

• Medical and Prescription Drug Benefit
• Life Insurance and Disability Benefits
• 401(k) Profit Sharing and Investment Plan(Includes annual Company financial contribution and discretionary Profit Sharing contribution based upon annual company financial results)
• Health Savings Account (HSA)
• Flexible Spending Accounts
• Tuition Assistance, Training, and Professional Designations
• Company-Paid Family Leave
• Adoption/Surrogacy Assistance Benefit
• Voluntary Benefits - Group Accident Insurance, Hospital Indemnity, Critical Illness, Legal,  Protection, Pet Insurance
• Student Loan Refinancing Services
• Membership with Back-up Care, Senior Solutions
• Business Travel Accident Insurance
• Matching Gifts program
• Employee Referral Award Program
• Wellness programs

Additional information

This position is a full time hourly, non-exempt (overtime eligible) position.

Utica National is an Equal Opportunity Employer.

:

:

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.

For further information, please review the Know Your Rights notice from the Department of Labor.