dcsimg

Career Story: Senior Case Analyst For An Insurance Company

Senior Case Analyst For An Insurance Company

Job Title: Senior Case Analyst

Type of Company: My company administers workers' compensation insurance claims for cities and towns across New York State.

Education: BA, English, SUNY-Albany

Previous Experience: I worked in an administrative capacity for several insurance companies both in the claims department and loss control department for about 7 years, before moving up into a beginner claims adjuster position (2 years), then a regular claims adjuster position (2 years), and finally as a senior claims adjuster.

Job Tasks: My primary job as a claims adjuster is to evaluate new workers' compensation claims for coverage and compensability, pay claims fairly and promptly, and bring claims to a prompt resolution. If an employee is injured on the job, it is his responsibility to report it to his employer in a timely manner, and it's the employer's responsibility to report it to our company in a timely manner.

When we receive the first notice of loss, it is assigned to a claims adjuster, who reviews the claim to see if it is covered. Contact is made with the injured worker and employer to explain coverage and benefits. If the injured worker is unable to work, workers' compensation pays a portion of their wages while they are disabled. When medical bills are received, they are reviewed to ensure that they are related to the covered claim, and they are adjusted according to a fee schedule and paid in a timely manner. When the injured worker returns to work, and when treatment concludes, the claim can be closed.

There are times when a claim must go before the Workers' Compensation Board, which is the governing body overseeing all workers' compensation insurance companies, and the claim is heard before a judge. This is an extremely simplified and basic description of the job; there are many rules and laws and regulations with workers' compensation insurance, and there are so many different claims scenarios to evaluate for coverage.

Best and Worst Parts of the Job: The best (and worst!) part of the job is that New York state has the most complicated, at times frustrating, and detailed workers' compensation system of any state in America! What this means is, you can't just walk into this job and "get it" in two weeks. It takes a long time to learn the system, and you really use your brain every single day. It is fascinating, never boring, and the pay is very good. Another frustrating thing is that the average person knows very little about workers' compensation, and has such a bad view of insurance companies in general, that when a claim isn't covered they usually get angry with the adjuster. It is important to remember that the adjuster doesn't make the rules and regulations, but they do have to follow them and try to explain benefits to the injured worker to the best of their ability. Luckily, the good days outweigh the bad.

Job Tips:
1. With a college degree, you can often become a claims adjuster at a bigger company with little or no experience. They will train you.

2. Get your adjuster's license and keep it current.

3. Take the Associate in Claims' courses for an AIC certification.

4. Learn as much as you can by doing. With workers' compensation, you can't learn everything from a book. I have been adjusting claims for 13 years, and I'm still learning.

Popular Schools offering Insurance Programs

quickinfoClick the Visit School Site buttons to go directly to a school's website and learn more about the school and programs it has to offer. School website will open in a new tab. .

Click the Request Info buttons to request more information from a representative at the school

Matching School Ads

Experience an education that helps you realize your potential in a way that fits you best. Request more information about Post University today.

  • Programs: Master of Business Administration - Multidisciplinary, Master of Business Administration (MBA), B.S. in Business Administration, more...
  • Degrees: Master, Bachelor

If you want to make the world a better place, start at the University of San Francisco. Our 21st-century mission to create a more humane and just world comes alive in our diverse learning community and is broadened by our global orientation. You are challenged to reach higher standards and to use your education to promote justice and serve the common good. At the University of San Francisco, youll find the excellence inherent in an institution established over 150 years ago, and inherent in nearly five centuries of Jesuit education.

  • Programs: Master of Public Administration
  • Degrees: Master

Which career path will you take – Business, Nursing, Education, Psychology? Something else? GCU offers more than 100 majors to get you started!

  • Programs: B.S. in Marketing
  • Degrees: Bachelor

As a student at South University, Online Programs, you will receive the same quality instruction, variety of learning options and level of service found at the campus locations.

  • Programs: Accounting (BS to MS), Accounting (MS)
  • Degrees: Master
UEI College
Bakersfield, Chula Vista, Encino, Fresno, Gardena, Ontario, San Marcos, Stockton

At UEI College, we want you to succeed. We’re like a family and we want you to be a part of it.

  • Programs: Business Office Administration (10-Month Diploma Program)
  • Degrees: Diploma

Abilene Christian University is a national leader in Christian higher education and a place where students, faculty, staff and alumni make a real difference in the world.

  • Programs: Master of Business Aministration
  • Degrees: Master

The Forbes School of Business® combines the power and flexibility of online learning with high-quality, topical Forbes content.

  • Programs: BA Public Administration, MA Public Administration
  • Degrees: Bachelor, Master

Regent University prepares students with the knowledge to excel and the faith to live with purpose.

  • Programs: Bachelor of Science in Professional Studies
  • Degrees: Bachelor

Pursue a certificate, master, or doctorate degree in Psychology at The Chicago School for Professional Psychology.

  • Programs:
  • Degrees:

A Rutgers business education prepares students for success – not just in their chosen fields but also in their lives.

  • Programs: Master of Governmental Accounting (Online)
  • Degrees: Master
Matching School Ads

Additional Career Stories for Claims Adjusters, Appraisers, Examiners, And Investigators

The inside stories from people actually working in the field.
Click a story title to show the story, and click the title again to hide it.

All Types

You are visiting:

Find a school near you

What are Career Stories?

Career Stories are concise, real-world career overviews written by people relating their personal career experiences and wisdom. They provide invaluable insights and mentoring advice to students and career changers.

Most stories include:

  • a typical day or project
  • tips and advice
  • best and worst parts
  • educational background
  • previous experience

Browse hundreds of Career Stories

Back to Top