Claims Examiner

This is a fully remote position, open to applicants in Texas.

📋 Description

• Evaluate Workers Compensation claims on behalf of clients to establish entitled benefits.

• Ensure the ongoing adjudication of claims aligns with service expectations, industry best practices, and client service standards.

• Analyze and process claims using action plans to achieve timely resolutions.

• Investigate and collect information to assess claim exposure.

• Negotiate settlements of claims within the specified authority limits.

• Communicate claim activities and processing updates with claimants and clients.

• Report claims to the excess carrier.

• Respond promptly and professionally to requests for direction.

⛳️ Requirements

• High School Diploma or GED is required.

• A Bachelor's degree from an accredited college or university is preferred.

• Professional certification relevant to the line of business is preferred.

• A minimum of 5 years of claims management experience or an equivalent combination of education and experience is required.

• Strong ability for clear and conceptual thinking.

• Excellent judgment, troubleshooting, problem-solving, analytical skills, and discretion.

• Capability to manage work-related stress effectively.

• Ability to juggle multiple priorities simultaneously.

• Proficiency in meeting deadlines.

• Competence in computer keyboarding.

• Willingness to travel as necessary.

• Ability to hear, see, and communicate effectively.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunities for career development and advancement.

• Medical, dental, and vision benefits.

• 401(k) enrollment from day one.

• 401(k) matching contributions.

• Paid time off (PTO).

• Disability insurance.

• Life insurance.

• Employee assistance programs.

• Flexible spending account or health savings account options.

• Additional voluntary benefits available.

• Reasonable accommodations provided where applicable and appropriate.