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Sr. Claims Examiner - Workers Compensation

Sr. Claims Examiner - Workers Compensation

Job Description


Sr. Claims Examiner - Workers Compensation 

 

The Senior Workers Compensation Claims Examiner investigates claims to determine an injured worker’s entitlement to Workers’ Compensation benefits.  He/she administers indemnity and medical benefits for valid Workers’ Compensation claims and manages a caseload of claims from inception to closing or settlement.  He/she assists Unit Manager with mentoring new claims examiner and/or supervisory functions.


  • Completes 3-point contact on new claims within 24 hours in order to obtain information necessary to make a compensability decision on the claim
  • Establishes appropriate reserve levels based on financial exposure and updates reserves upon receipt of new information
  • Directs assistant to properly pay indemnity benefits payments and Awards. Issue state-mandated benefit notices within the required timeframes.
  • Annotates, categorizes and addresses incoming mail on a daily basis.
  • Responding to questions and requests from the client.

Job Requirements


Sr. Claims Examiner - Workers Compensation 

 

Skills/Abilities:

  • Ability to prioritize multiple tasks and meet deadlines
  • Excellent written and verbal skills
  • Excellent customer service skills

 

Knowledge:

  • Workers’ Compensation law; policies and procedures
  • Medical and legal terminology, Integration with Medicare
  • Required Experience


Education:

  • BS / BA or Equivalent Work Experience


Experience:

  • 5 to 8 years

Job Snapshot

Base Pay $65,000.00 /Year
Employment Type Full-Time
Job Type Insurance
Education Not Specified
Experience At least 4 year(s)
Manages Others Not Specified
Industry Insurance
Required Travel Not Specified
Job ID 9764
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Sr. Claims Examiner - Workers Compensation


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