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Workers Compensation Claims Examiner

Job Description

The Workers Compensation Claims Examiner investigates claims to determine an injured worker’s entitlement to Workers’ Compensation benefits;  Administers indemnity and medical benefits for valid Workers’ Compensation claims;  Manages a caseload of claims from inception to closing or settlement.

Essential 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 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

Education, Experience and Skills Required:
    • 3 to 10 years of related experience
    • Ability to prioritize multiple tasks and meet deadlines
    • Excellent written and verbal skills
    • Excellent customer service skills
    • Workers’ Compensation law, policies and procedures
    • Medical and legal terminology
    • Integration with Medicare
    • BS / BA or Equivalent Work Experience

Job Snapshot

Other Pay Excellent Benefits
Employment Type Full-Time
Job Type Insurance, Customer Service
Education 4 Year Degree
Experience At least 3 year(s)
Manages Others No
Industry Insurance
Required Travel None
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Workers Compensation Claims Examiner

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