Claims Examiner II

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

📋 Description

• Manage assignments related to lost time and medical-only claims.

• Maintain a claim inventory as directed by management, with approximately 50 open claims at any time.

• Assess, research, and evaluate claims to recommend appropriate coverage, utilizing discretionary judgment.

• Establish timely communication with members, injured workers, agents, providers, attorneys, and others as necessary.

• Investigate claims through phone interviews and emails, while obtaining necessary documentation.

• Assess exposure and adjust reserves as needed.

• Finalize claims processing in alignment with company standards.

• Meet with members, agents, injured workers, attorneys, and others when necessary.

• Provide training and serve as a mentor for members and other claims staff.

• Complete special projects as assigned by the Claims Leader.

• Travel to the annual workers' compensation conference and/or attend educational seminars.

• Engage in personal and professional development activities.

⛳️ Requirements

• Minimum educational qualifications required.

• Proficiency in Microsoft Office, Windows, Excel, IVOS, and related software.

• Excellent telephone etiquette.

• Ability to uphold a high level of confidentiality.

• 3 to 5 years of experience in a similar role.

• Associate’s or Bachelor’s degree in business, a financial-related discipline, or Human Resources is preferred.

🏝️ Benefits

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance.

• Financial Benefits: Employee Stock Purchase Plan (ESPP), 401k, Student Loan Assistance, Tuition Reimbursement.

• Mental Health & Wellness: Access to Free Mental Health Services and Enhanced Advocacy Services.

• Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts, and more.