Claims Examiner III

Markel • Henderson, NV

7d • $82,250 - $171,450

About The Position

Responsible for resolving high-complexity, high-exposure Workers Compensation claims across multiple jurisdictions. The role carries increased decision-making responsibility within the examiner’s authority and works under general direction from a manager. The examiner investigates and evaluates claims, determines coverage and exposure, manages reserves, and drives claims toward resolution, including returning injured workers to work. Travel to mediations, trials, and conferences is required as needed.

Requirements

• California Claims Examiner Certification.
• Excellent written and verbal communication skills.
• Strong analytical, problem-solving, organizational, and time-management skills.
• Ability to deliver outstanding customer service and work effectively in a team environment.
• Intermediate proficiency with Microsoft Office applications, including Excel, Outlook, and Word.
• Demonstrated commitment to continuous improvement and professional development.
• Ability to analyze complex coverage, liability, compensability, and medical-management issues and make sound claim decisions.
• Strong negotiation and decision-making skills.
• US work authorization; Markel does not provide visa sponsorship for this position, now or in the future.

Nice To Haves

• Bachelor’s degree in a business-related field; equivalent insurance industry experience may be substituted.
• Strong understanding of medical terminology.

Responsibilities

• Confirm claim coverage by reviewing policies and supporting documents.
• Analyze coverage and communicate coverage positions.
• Conduct, coordinate, and direct investigations into loss facts and the extent of damages.
• Direct and monitor assignments to experts and outside counsel.
• Evaluate coverage, compensability, and medical-management information to determine insured exposure.
• Set reserves within authority or recommend reserve changes to the manager.
• Drive claims toward resolution, focusing on returning injured workers to work.
• Evaluate, negotiate, and settle claims when appropriate.
• Prepare reports by collecting and summarizing information.
• Follow Fair Claims Practices regulations and internal Claims Quality Performance Objectives.
• Participate in special projects or assist other team members as requested.
• Attend scheduled state-specific training.
• Travel to mediations, trials, and conferences as required.

Benefits

• Multiple health insurance plan options
• Multiple dental insurance plan options
• Multiple vision insurance plan options
• Optional life insurance
• Disability insurance
• AD&D insurance
• 401(k) with employer match contributions
• Employee Stock Purchase Plan
• PTO
• Corporate holidays and floating holidays
• Parental leave
• May be eligible to participate in the Company’s annual incentive plan

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed