Workers Compensation Claims Examiner

TEKsystems•Happy Valley, OR

22h•$46 - $48•Hybrid

About The Position

This is a contract position based out of Portland, OR. The role involves handling workers' compensation claims, determining policy obligations, conducting investigations, evaluating liability, and settling claims. The position offers a hybrid work model, with initial full-time in-office work followed by a hybrid schedule of 3 days in-office and 2 days remote. The work schedule is 8:00 am - 4:30 pm PCT with a 1/2 hour lunch break. Free parking and public transportation are available, and the location is conveniently situated right off the highway, close to Tigard.

Requirements

2 or more years of experience handling workers' compensation claims.
Strong communication and interpersonal skills to effectively interact with claimants, customers, insureds, brokers, attorneys, etc., in a positive manner regarding losses.
Ability to self-motivate and work independently.
Knowledge of company products, services, coverages, and policy limits along with awareness of the company's claims best practices.

Nice To Haves

CA Claims experience is a plus.

Responsibilities

Under limited supervision, receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.
Contacts, interviews, and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc., to secure necessary claim information.
Evaluates facts supplied by investigation to determine the extent of liability of the insured, if any, and the extent of the company's obligation to the insured under the policy contract.
Prepares reports on investigation, settlements, denials of claims, and individual evaluation of involved parties.
Sets reserves within authority limits and recommends reserve changes to the Team Leader.
Prepares and submits unusual or possible undesirable exposures to the Team Leader.
Settles claims promptly and equitably.
Obtains releases, proofs of loss, or compensation agreements and issues company drafts in payment for claims.
Informs claimants, insureds/customers, or attorneys of denial of claim when applicable.