Claims Examiner II

Employer’s Claim Management•Montgomery, AL

About The Position

Employer’s Claim Management is seeking an experienced Workers’ Compensation Claims Examiner II with a strong background in Alabama workers’ compensation claims handling. The role is intended for a knowledgeable, self-directed professional who can manage a full caseload, apply Alabama Workers’ Compensation law, and build trusted relationships with everyone involved in the claims process. The examiner will evaluate, reserve, and resolve claims while contributing to a collaborative team and serving injured employees and employers. The position involves independently managing Alabama workers’ compensation claims from inception through resolution, including investigating compensability, handling payments and reserves, coordinating with medical and legal professionals, negotiating settlements, and maintaining accurate claim records. The examiner may travel for claim-related activities and has flexible work-from-home options available. The company describes its work as helping employees injured in work-related accidents and helping employers promote workplace safety. It emphasizes teamwork, mutual respect, accountability, continuous improvement, and meaningful service. Compensation is competitive, and the company offers a benefits package that includes insurance coverage, retirement matching, paid time off, and flexible spending accounts.

Requirements

A minimum of 3 years of Alabama workers’ compensation claims handling experience is desirable.
Knowledge of Alabama Workers’ Compensation law and proven experience applying the law to claims.
Good working knowledge of medical and legal terminology related to workers’ compensation.
Ability to analyze complex information, evaluate exposure, and make informed decisions regarding compensability, benefits, and settlement.
Excellent verbal and written communication skills.
Ability to communicate effectively with claimants, employers, physicians, nurses, insurance agents, and attorneys.
Strong interpersonal skills and ability to work collaboratively within a team environment.
Demonstrated time management and organizational skills, including the ability to manage multiple claims efficiently.
Proficiency with Microsoft Office products and claims management technology.
Self-motivated professional who values accuracy, accountability, and continuous learning.

Responsibilities

Develop professional relationships with claimants, employers, medical providers, attorneys, and vendors.
Independently manage a full caseload of Alabama workers’ compensation claims from inception through resolution.
Conduct thorough investigations to determine compensability and identify potential defenses.
Establish, review, and maintain appropriate claim reserves.
Calculate and issue workers’ compensation indemnity and medical benefit payments accurately and timely.
Maintain regular communication with employers, providing clear status updates and strategic recommendations.
Visit claimants as necessary on catastrophic or other complex claims.
Coordinate and collaborate with nurse case managers, investigators, and other outside vendors as needed.
Negotiate and resolve claims within assigned authority.
Work closely with legal counsel on litigated claims, including discovery assistance, strategy development, and resolution planning.
Travel to mediations, depositions, trials, meetings with employers or medical vendors, and workshops or seminars as necessary.
Ensure complete, accurate, and timely documentation of all claim activity in the claims management system.
Serve as a resource to team members by sharing expertise and best practices as needed.