Workers Compensation Claims Examiner | Dedicated Client | Jurisdictions: DE, IL, LA, MO, NJ, OK, TN, TX | Licensing: Required | Litigation Experience
About The Position
The Workers Compensation Claims Examiner analyzes lost-time workers’ compensation claims on behalf of clients to determine benefits due. The role ensures ongoing claim adjudication meets service expectations, industry best practices, and specific client service requirements. The examiner investigates and gathers information, develops action plans to resolve claims, negotiates settlements within designated authority, communicates claim activity to claimants and clients, and reports claims to excess carriers while responding to requests for direction. This is a dedicated-client role requiring jurisdiction knowledge for Delaware, Illinois, Louisiana, Missouri, New Jersey, Oklahoma, Tennessee, and Texas. A home-state license plus licenses for Delaware, Louisiana, Oklahoma, and Texas are required. Heavy litigation experience is required.
Requirements
- High school diploma or GED.
- Five years of claims management experience, or an equivalent combination of education and experience.
- Heavy litigation experience.
- Home-state license plus licenses for Delaware, Louisiana, Oklahoma, and Texas.
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 well-developed 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 coverage.
- 401(k) and matching.
- Paid time off (PTO).
- Disability insurance.
- Life insurance.
- Employee assistance program.
- Flexible spending account or health savings account.
- Additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
