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Claims Associate Workers Compensation Jobs in Rochester, NY

Erie Insurance

Liability Specialist

Rochester, NY · On-site

$63K - $100K/yr

Associate degree and three years of claims related experience required; or * Bachelor's degree and one year of claims related experience required. Additional Experience * Working knowledge of ...

Erie Insurance

Liability Specialist

Rochester, NY

$63K - $100K/yr

Associate degree and three years of claims related experience required; or * Bachelor's degree and one year of claims related experience required. Additional Experience * Working knowledge of ...

CRH

Safety Coordinator

Rochester, NY

$60K - $70K/yr

... support workers' compensation and liability claims processes * Recommend safety innovations ... Associate or Bachelor's degree in EHS, Occupational Safety, or related field * 1+ years of ...

O'Connell Electric Company

Associate Counsel

Victor, NY · On-site

$85K - $100K/yr

Associate Counsel O'Connell Electric Company is looking for a hard-working and well-qualified ... Compensation The minimum and maximum annual salary (or hourly rates) that O'Connell Electric ...

O'Connell Electric Company

Associate Counsel

Victor, NY · On-site

$85K - $100K/yr

Associate Counsel Victor, New York O'Connell Electric Company is looking for a hard-working and ... Compensation The minimum and maximum annual salary (or hourly rates) that O'Connell Electric ...

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Claims Associate Workers Compensation information

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How much do claims associate workers compensation jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for claims associate workers compensation in Rochester, NY is $20.71, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $22.79 per hour, depending on experience, location, and employer.

What does a claims associate in workers compensation do?

A Claims Associate for Workers Compensation is responsible for reviewing, processing, and managing claims filed by employees who have been injured on the job. Their duties include investigating the circumstances of the injury, verifying coverage, determining the validity of claims, and ensuring timely payments to claimants. They work closely with medical professionals, employers, and sometimes legal representatives to gather necessary documentation and resolve claims efficiently. Their role is crucial in helping injured workers receive the benefits they are entitled to while protecting employers from fraudulent or exaggerated claims.

What are the key skills and qualifications needed to thrive as a claims associate in workers compensation?

To thrive as a Claims Associate in Workers Compensation, you need a solid understanding of insurance principles, claims processing, and relevant state regulations, typically supported by a bachelor's degree or relevant work experience. Familiarity with claims management software (such as Guidewire or ClaimCenter), as well as industry certifications like AIC (Associate in Claims), is often required. Attention to detail, strong organizational skills, and effective communication set top performers apart in this role. These skills ensure accurate claim handling, compliance with legal standards, and excellent customer service for both claimants and employers.

What are some common challenges faced by claims associates in workers compensation, and how can they be managed?

Claims Associates in Workers Compensation often encounter challenges such as managing a high caseload, interpreting complex medical and legal documents, and handling sensitive communications with claimants and employers. Staying organized and prioritizing tasks can help manage workload, while ongoing training and collaboration with medical professionals and legal teams enhance understanding of complex cases. Building strong communication skills is also crucial for navigating difficult conversations and ensuring all parties are informed throughout the claims process.

What are popular job titles related to Claims Associate Workers Compensation jobs in Rochester, NY?

For Claims Associate Workers Compensation jobs in Rochester, NY, the most frequently searched job titles are:

What job categories do people searching Claims Associate Workers Compensation jobs in Rochester, NY look for?

The top searched job categories for Claims Associate Workers Compensation jobs in Rochester, NY are:

What cities near Rochester, NY are hiring for Claims Associate Workers Compensation jobs?

Cities near Rochester, NY with the most Claims Associate Workers Compensation job openings:

Claims Associate Workers Compensation jobs near you

Clm Resltion Rep III, Hosp/Prv

University of Rochester

Rochester, NY • Remote

$20.30 - $27.41/hr

Full-time

Re-posted 15 days ago

University Of Rochester rating

8.3

Company rating: 8.3 out of 10

Based on 186 frontline employees who took The Breakroom Quiz

128th of 621 rated colleges and universities

Job description

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

Remote Work - New York, Albany, New York, United States of America, 12224

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

910402 United Business Office

Work Shift:

UR - Day (United States of America)

Range:

UR URCA 205 H

Compensation Range:

$20.30 - $27.41

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Responsibilities:

GENERAL PURPOSE
The Claims Resolution Representative III is responsible for working across the professional fee organization, handling follow-up activities designed to bring all open accounts receivable to successful closure. Responsible for effective claims follow-up on complex, multi-faceted accounts to obtain maximum revenue collection and closure. Responsibilities include, but are not limited to, independent research, claim correction and resubmission, handling payer specific appeal process taking timely and routine action to resolve unpaid claims. The Claims Resolution Representative III reports to Accounts Receivable Management.

ESSENTIAL FUNCTIONS

With general direction of the Manager/Supervisor/Lead:

  • 40% Follows department policies and procedures and maintains and exercises comprehensive knowledge of insurance company billing requirements and regulations to research and resolve unpaid accounts receivable, making any corrections in the professional billing system necessary to ensure balance resolution for all assigned URMFG physician services.
  • 25% Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc. Research claims, identify problems, and takes appropriate action to assure claim resolution.
  • 20% Responds to all billing-related inquiries from colleagues, departments, patients, and payors in a timely and professional manner. Communicates any missing/incomplete information to providers and department administrative support staff to ensure accurate billing. Communicates with insurance representatives through telephone calls, payer website, and written communication to ensure accurate processing of claims. Collaborate with appropriate departments to generate a detailed rational for appeals and grievances to the insurance companies.
  • 10% Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. Escalates system issues preventing claims submission and follow-up for review and resolution.
  • 5% Collaborates with Claim Edit Specialists and Patient Medical Billing Specialists assigned to pre claim WQ's to identify opportunities for improvement in clean claims rate.

May perform other duties as assigned.


QUALIFICATIONS

Required:

  • Associate degree and 2 years of related relevant experience; or equivalent combination of education and/or experience
  • Excellent problem-solving skills
  • Excellent communication skills
  • Excellent customer service skills

Preferred:

  • Strong working knowledge of the professional billing software applications
  • Ability to type 25 wpm.

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University's Mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status,or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.

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