Workers' Compensation Claims Examiner III

Job Summary

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

Key responsibilities

• Effectively manage and investigate claims, determining compensability and administering benefits according to state law
• Communicate with claimants, providers, and vendors to resolve claims issues and ensure timely processing
• Set reserves, settle claims, and maintain accurate documentation and diary systems for case reviews

Required qualifications

• Bachelor's degree in a related field preferred, or equivalent combination of education and experience
• Three (3) or more years of related experience in 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