Workers Compensation Claims Examiner I
About The Position
Under close supervision, the Workers Compensation Claims Examiner I manages Medical Only workers’ compensation claims from inception through conclusion, within established authority and guidelines. The role handles a caseload of approximately 150 to 200 files and requires frequent interaction by phone with clients, claimants, providers, and vendors, as well as communication with management, other Claims Examiners, and other TRISTAR staff. Timely, consistent attendance at the office or applicable home office location is an inherent requirement of the position. The position requires an Oregon or Washington adjuster’s license, or willingness and ability to obtain the required license or certification. It is a full-time, day-shift role in Lake Oswego, Oregon, with no travel required. The listed pay range is $24.00 to $30.00 per hour.
Requirements
- High school diploma or GED is listed as the education level for the position.
- One year of related experience, or an equivalent combination of education and experience.
- Technical knowledge of statutory regulations and medical terminology.
- Analytical skills.
- Excellent written and verbal communication skills, including the ability to convey technical details to claimants, clients, and staff.
- Ability to interact with people at all levels in a business environment.
- An Oregon or Washington certification and/or license, or the ability to become certified or licensed.
- Willingness to obtain the required Oregon or Washington adjuster’s license if not already licensed.
- Proficiency in Word and Excel is listed as preferred.
Nice To Haves
- Bachelor’s degree in a related field.
- Proficiency in Word and Excel.
Responsibilities
- Manage a caseload of 150 to 200 Medical Only workers’ compensation files.
- Determine claim compensability.
- Manage medical treatment and medical billing.
- Communicate with claimants, providers, and vendors about claims issues.
- Maintain a diary system for case review and document files to reflect claim status and work performed.
- Promptly communicate appropriate information to clients to resolve claims efficiently.
- Adhere to company policies and procedures.
- Participate in file reviews as needed.
- Perform other assigned duties, including assisting as a claims assistant.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
