Claims Examiner - Workers Compensation | Jurisdiction: Southeast States | Licensing: FL or home state required - Remote
About The Position
The Claims Examiner analyzes workers’ compensation claims on behalf of clients to determine benefits due. The role ensures ongoing claim adjudication meets service expectations, industry best practices, and specific client service requirements. The position covers jurisdictions in the Southeast and requires a Florida or home-state license. The examiner investigates claims, gathers information, assesses exposure, develops action plans, and processes claims toward timely resolution. The role also includes negotiating settlements within designated authority, communicating claim activity and processing to claimants and clients, and reporting claims to excess carriers while responding promptly and professionally to requests for direction.
Requirements
- High school diploma or GED required.
- Five years of claims management experience, or an equivalent combination of education and experience, required.
- Florida or home-state license required.
- Jurisdiction knowledge covering Florida, Georgia, North Carolina, South Carolina, Alabama, Arkansas, and Kentucky.
Nice To Haves
- Bachelor's degree from an accredited college or university.
- Professional certification applicable to the line of business.
Responsibilities
- Analyze and process claims using well-developed action plans to reach appropriate and timely resolutions.
- Investigate claims and gather information to determine claim exposure.
- Negotiate claim settlements within designated authority.
- Communicate claim activity and processing with claimants and clients.
- Report claims to excess carriers and respond to requests for direction professionally and promptly.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- Medical, dental, and vision coverage.
- 401(k) and matching.
- Paid time off (PTO).
- Disability and life insurance.
- Employee assistance program.
- Flexible spending or health savings account.
- Additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
