Workers Compensation Claims Examiner III

Tristar Insurance•Irving, TX

7h•$76,000 - $80,000•Onsite

About The Position

Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; therefore consistently being at work in the office, in a timely manner, is inherently required of this position.

Requirements

Education/Experience: High School Diploma or GED required; Bachelor’s degree in related field (preferred); five (5) or more years related experience; or equivalent combination of education and experience.
Workers’ Compensation Adjusters License current for the State of Texas
MENTAL EFFORT
Solve practical problems; variety of variables with limited standardization; interpret instructions.
Arithmetic calculations involving fractions, decimals, and percentages.
Ability to compose original correspondence, follow technical manuals, and have increased contact with people.
PHYSICAL EFFORT
Light work:
a. Exerting up to 20 pounds of force occasionally
b. Exerting up to 10 pounds frequently
c. Exerting a negligible amount of force constantly to move objects
Near vision: clarity of vision at 20 inches or less
Mid-range vision: clarity of vision at distances of more than 20 inches and less than 20 feet
Stooping: Bending body downward and forward by bending spine at the waist. This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.
Kneeling: Bending legs at knee to come to a rest on knee or knees.
Crouching: Bending the body downward and forward by bending legs and spine.
Reaching: Extending hand(s) and arm(s) in any direction.
Standing: Particularly for sustained periods of time.
Walking: Moving about on foot to accomplish tasks, particularly for long distances.
Pushing: Using upper extremities top press against something with steady force in order to thrust forward, downward, or outward.
Pulling: Using upper extremities to extent force in order to drag, haul, or tug objects in a sustained motion.
Lifting: Raising objects from a lower to a higher position or moving objects horizontally from position to position. This factor is important if it occurs to a considerable degree and requires substantial use of the upper extremities and back muscles.
Fingering: Picking, pinching, typing, or otherwise working with fingers rather than with the whole hand or arm as in handling.
Grasping: Applying pressure to an object with the fingers and palm.
Talking: Expressing or exchanging ideas by means of the spoken word. Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.
Hearing: Perceiving the nature of sounds with or without correction. Ability to receive detailed information through verbal communication, and to make fine discriminations in sound, such as when making find adjustments on machined parts.
Repetitive Substantial movements (motions) of the wrists, hands, and/or fingers.

Nice To Haves

Bachelor’s degree in related field (preferred)

Responsibilities

Handle loss time Workers’ Compensation claims in TX Office—Texas Jurisdiction
Handle claims as per BP , SOC 1 and client CHI’s
The ability to prepare a formal captioned report on claims meeting client requirements
Well organized and CAN DO attitude.
Ability to effectively communicate in a professional manner
Provide great customer service
Assist employers and their employee’s understand the WC process
Investigate, evaluate, determine compensability, pay benefits timely as required and comply with all statutory requirements
A good sense of urgency
Ability to get along well with others with a positive attitude