Part Time Claims Adjudicator Jobs (NOW HIRING)

Claims Manager, No Fault - 01068669

---

Agency: MTAHQ

Job Title: Claims Manager, No Fault

Department: 860001

Division: 860000

Job Family: Compliance & Audit

Grade: 005

Reports To: Dep Gen Counsel A - Pension

Work Location: 130LVNGSTN

Full Time/Part-Time: F

Hours of Work: 7.5

Union: Non-Represented Position

MTA Headquarters reserves the right to remove this posting before the application deadline
The Metropolitan Transportation Authority is North America's largest transportation network, serving a population of 15.3 million people across a 5,000-square-mile travel area surrounding New York City, Long Island, southeastern New York State, and Connecticut. The MTA network comprises the nation’s largest bus fleet and more subway and commuter rail cars than all other U.S. transit systems combined. MTA strives to provide a safe and reliable commute, excellent customer service, and rewarding opportunities.
Telework:
This position is eligible for telework which is currently one day per week. New hires are eligible to apply 30 days after their effective date of hire.
Job Summary:
Claims Manager, No Fault manages the end-to-end adjudication of no-fault insurance claims, emphasizing accurate coverage analysis, legally compliant benefit determinations, and timely resolution of claim files. Claims Manager, No Fault is responsible for directing and overseeing no-fault claims handling and settlement decisions, interpreting and applying no-fault statutes and case law to complex claims, and developing and maintaining guidelines, procedures, and quality controls that govern no-fault claims adjudication. In addition to supervising a team of Claims Examiners and support staff, the Claims Manager, No Fault will also maintain and handle a claims caseload. This role directly reports to the Director, No Fault.
Responsibilities:

• Direct and oversee no-fault claims handling, coverage analysis, benefit determinations, and settlement decisions to ensure accurate, timely, and legally compliant claim resolution


• Supervise a team of claims examiners and administrative staff


• Provide legal and technical guidance to claims staff on liability evaluation, benefits eligibility, litigation exposure, and negotiation strategies for no-fault claims


• Review no-fault claims submitted by claimants, medical providers, and hospitals to ensure completeness and compliance with applicable regulations and internal standards


• Interpret and apply applicable no-fault statutes, regulations, policy language, and case law, including New York State Regulation 68, to complex claim files and coverage disputes


• Process approved no-fault claims for payment using the computerized no-fault system and related claim platforms in accordance with established controls


• Prepare no-fault claim cases for arbitration proceedings, including file review, documentation, and coordination under established legal and procedural guidelines


• Respond to telephone and written inquiries from medical service providers, hospitals, and claimants regarding claim status, required documentation, and benefit determinations


• Develop, implement, and maintain guidelines, procedures, and quality controls for no-fault claims adjudication, documentation standards, and file review practices
• Performs other duties as assigned


• Complies with all policies and standards


• May be required to work hours outside regular work hours, as applicable


• Observes the work performed by contractors, as applicable


• Reviews invoices and approves them if the work has contractual standards, as applicable


• Addresses performance issues with the contractor when possible, as applicable


• Escalates issues to other parties when needed, as applicable

Education:

• Bachelor’s Degree in Arts/Sciences (BA/BS) A baccalaureate degree from an accredited college including or supplemented by 6 credits in mathematics, statistics, accounting and/or actuarial science and two years of full-time experience involving the use of mathematical, statistical, actuarial or accounting computations Required or


• Associate’s Degree (AA) Associate degree with coursework in mathematics, statistics, accounting, actuarial science, or related quantitative field and five to seven years experience as described in "1" above Required or


• H.S. Diploma or General Education Degree (GED) High school diploma or equivalent with substantial experience in benefit plan or claims administration and eight years of full-time experience as described in "1" above Required

Experience:

• Minimum 4 years Experience in no-fault or similar insurance claims management, including responsibility for complex claim files and payment determinations Required and


• Minimum 2 years Experience implementing provisions of retirement, workers’ compensation, or medical benefit plans involving mathematical, statistical, actuarial, or accounting computations Required and


• Minimum 2 years Experience managing a team who interfaces with internal departments and the general public Required

Skills and Abilities:

• Insurance claims management Required


• No-fault insurance Required


• Legal research Required


• Regulatory compliance Required


• Negotiation Required


• Risk analysis Required


• People management Required


• Data analysis Preferred


• Process improvement Preferred


• Stakeholder management Required

Additional Information:
Job posting and target salary range: $99,204 - $110,227.
Final salary is determined experience, skillset, and alignment with compensation practices. The posted range reflects expected compensation and may be updated as market or business needs evolve.
To be eligible for consideration for a new role, current MTA employees must complete at least one year of service in their current role prior to applying. Additionally, eligibility to interview is contingent upon maintaining a satisfactory record of job performance, attendance, and disciplinary conduct.
Pursuant to the New York State Public Officers Law & the MTA Code of Ethics, all employees who hold a policymaking position must file an Annual Statement of Financial Disclosure (FDS) with the NYS Commission on Ethics and Lobbying in Government (the “Commission”).
How to Apply:
For Internal Applicants:
Log in to the My MTA Portal, click on the My Job Search tile, select the Careers link, search for the desired position, click Apply, and follow the on-screen instructions.
For External Applicants:
Visit www.mta.info, click the “Careers” link located in the footer under the "The MTA" section, then click on “See All Open MTA Positions”.
Search for the desired position, click Apply, and follow the instructions.
Comprehensive Benefits & Total Rewards Package:
Transportation & Financial Benefits

• Commuting Made Easy – Enjoy a complimentary MTA transportation pass, plus access to tax-advantaged commuter benefits to maximize your savings.


• Premium Health Coverage at Low Cost – Access high-quality individual, family and domestic partner healthcare, dental, vision and life insurance plans.


• Secure Your Future – Build long-term financial security through pension plans and retirement savings accounts designed for eligible employees.

Time Off & Work-Life Balance

• Generous Time Away – Recharge with substantial paid time off and comprehensive holiday schedules that support your personal and family commitments.


• Holistic Support Services – Access our dedicated Work Life Services team and Office of the Chaplains unit for personal guidance and support when you need it most.

Professional Growth & Development

• Learning & Development Program – Advance your career through structured professional development opportunities, skills training, and leadership programs tailored to support your growth within the organization.


• Educational Investment – Pursue your career goals with in-house training and professional development, tuition reimbursement support, and partnerships with educational institutions.

Employee Experience & Community

• Employee Assistance Programs – Comprehensive support services to help you navigate life's challenges with confidence and resources.


• Discounts & Perks – Take advantage of MTA employee discount programs offering savings on products and services.


• Connect & Belong – Join our vibrant Employee Resource Groups to build meaningful connections, share experiences, and contribute to an inclusive workplace culture.

MTA and its subsidiary and affiliated agencies are Equal Opportunity Employers, including with respect to veteran status and individuals with disabilities. The MTA encourages qualified applicants from diverse backgrounds, experiences, and abilities, including military service members, to apply.