Staff Analyst Series (No Fault Claims)

### Description *Position at MABSTOA* **** | **Title: Staff Analyst Series (No Fault Claims)** | **Department: Legal** | | --- | --- | | **Authority: NYCT (OA)** | **Division/Unit: General Counsel** | | **Work Location: College Point Depot - Flushing, NY** | **Hours of Work: 9:00am – 5:00pm** | | **Compensation:** | | | **Associate Staff Analyst (OA – Represented by TWU):** | **$93,453- $121,004** | | **Staff Analyst II (OA – Represented by TWU):** | **$82,673 – $92,077** | | **Staff Analyst I (OA – Represented by TWU):** | **$71,203 - $84,295** | | **Deadline (if Applicable):** | **Until Filled** | | **Reporting Manager (If Applicable):** | **Claims Manager, No Fault** | **** **POSITION SUMMARY** The Claims Examiner evaluates, adjudicates, and resolves no-fault insurance claims in accordance with legal, regulatory, and policy requirements, ensuring accurate coverage determinations and timely benefit payments. No Fault Claims Examiner is responsible for analyzing claim documentation and medical records to determine coverage and compensability, applying relevant statutes and policy provisions to make liability and benefit decisions, and communicating determinations and required actions to involved parties in a clear and compliant manner. **RESPONSIBILITIES** - Analyze no-fault insurance claims, supporting documentation, and medical records to determine coverage, compensability, and benefit eligibility in accordance with applicable laws, regulations, and policy provisions. - Apply legal, regulatory, and policy requirements to evaluate liability, calculate benefits, set reserves, and make adjudication decisions on no-fault claims, documenting rationale and outcomes in claim systems. - Communicate clearly, both verbally and in written reports, claim determinations, required actions, and rationale to claimants, legal representatives, medical providers, and internal stakeholders in a clear, neutral, and compliant manner. - Identify, investigate, and resolve potential fraud indicators or discrepancies by reviewing records, requesting additional information, and coordinating with internal or external investigative resources. - Monitor and manage assigned claim inventory to meet timeliness, quality, and regulatory standards, prioritizing activities based on risk, complexity, and statutory deadlines. - Maintain accurate and complete electronic claim files, including notes, documentation, and correspondence, to support audit, litigation, and regulatory review requirements. - Collaborate with legal, medical, and operational resources to address complex coverage issues, disputes, and litigation, providing claim file analysis and factual summaries as needed. **EDUCATION AND EXPERIENCE** **Associate Staff Analyst** 1. A master’s degree from an accredited college or university in economics, finance, accounting, business or public administration, human resources management, management science, operations research, organizational behavior, industrial psychology, statistics, personnel administration, labor relations, psychology, sociology, human resources development, political science, urban studies, or a Juris Doctor degree from an accredited law school, and one year of satisfactory full-time professional experience in one or a combination of the following: working with the budget of a large public or private concern in budget administration, accounting, economic or financial administration, or fiscal or economic research; in management or methods analysis, operations research, organizational research or program evaluation; in personnel or public administration, recruitment, position classification, personnel relations, labor relations, employee benefits, staff development, employment program planning/administration, labor market research, economic planning, social services program planning/evaluation, or fiscal management, or in a related area; or 2. A baccalaureate degree from an accredited college or university and three years of satisfact…