About The Position
The Claims Examiner analyzes workers’ compensation claims on behalf of clients to determine benefits due and ensure claims are adjudicated in accordance with service expectations, industry best practices, and client requirements. The role investigates claims, gathers information to assess exposure, and works toward appropriate and timely resolutions. It also involves negotiating settlements within assigned authority, communicating claim activity with claimants and clients, and reporting claims to excess carriers while responding to their requests for direction.
Requirements
- High school diploma or GED.
- Five years of claims management experience, or an equivalent combination of education and experience.
- Knowledge of South Carolina and North Carolina jurisdictions.
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 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 benefits.
- 401(k) benefits 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
