About The Position
The Claims Examiner analyzes Workers Compensation claims on behalf of clients to determine benefits due and ensure claims are adjudicated within service expectations, industry best practices, and client service requirements. The role involves investigating claims, assessing exposure, developing action plans, negotiating settlements within designated authority, communicating with claimants and clients, and reporting claims to excess carriers. The position is described as hybrid/remote and includes a flexible work schedule, professional development, and promotional growth opportunities.
Requirements
- High school diploma or GED.
- Five years of claims management experience or an equivalent combination of education and experience.
- Florida licensing required.
- Jurisdictions include CA, FL, GA, MS, MI, NJ, OK, PA, TN, TX, and VI.
- Ability to think clearly and conceptually, exercise sound judgment and discretion, troubleshoot, solve problems, analyze information, manage work-related stress and multiple priorities, and meet deadlines.
- Ability to perform computer keyboarding and travel as required.
- Hearing, vision, and talking abilities.
Nice To Haves
- Bachelor's degree from an accredited college or university.
- Professional certification applicable to the line of business.
- California license preferred.
Responsibilities
- Analyze and process claims using action plans to reach appropriate and timely resolutions.
- Investigate claims and gather information to determine claim exposure.
- Negotiate 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 benefits.
- 401(k) available on day one.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
