Workers' Compensation Claims Examiner

Job Summary

Managing a caseload of 150 to 180 complex workers' compensation claims, the full-time Workers' Compensation Claims Examiner III will handle all aspects of claims from inception to conclusion while working remotely in a temporary position.

Key responsibilities

• Conducts timely investigations and determines compensability of claims in accordance with state law and company guidelines
• Manages medical treatment and billing, authorizing as appropriate, and communicates with claimants, providers, and vendors regarding claims issues
• Settles and finalizes claims, maintaining accurate documentation and adhering to company policies and procedures

Required qualifications

• Bachelor's degree in a related field (preferred) or equivalent combination of education and experience
• Three or more years of related experience in workers' compensation claims handling
• Technical knowledge of statutory regulations and medical terminology
• Ability to independently manage very complex claims effectively
• Certifications and/or licenses as required by state regulation