Claims Examiner – Workers Comp

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

📋 Description

• Evaluate and address intricate or technically challenging general liability claims by conducting investigations and collecting information to assess claim exposure.

• Oversee claims using well-structured action plans to ensure appropriate and timely resolutions.

• Manage the litigation process while ensuring claims are resolved in a timely and cost-effective manner.

• Coordinate referrals to vendors for further investigation and/or litigation management.

• Facilitate team meetings and assign accountability for follow-up tasks.

• Compile compliance and claims processing data for team meetings.

• Assist in interviewing adjusters and clerical personnel and provide constructive feedback to the hiring manager.

• Aid the team lead in conducting monthly reviews of adjuster workloads, identifying trends, and recommending adjustments.

• Implement company personnel policies while adhering to staffing standards and training guidelines.

• Conduct interviews, hire personnel, establish performance development plans, and lead performance discussions.

• Offer support, guidance, leadership, and motivation to the team.

• May supervise up to three direct reports.

⛳️ Requirements

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

• High School Diploma or GED is mandatory.

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

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

• Home State license is required.

• Understanding of nationwide jurisdiction is essential.

• Capability to analyze intricate or technically challenging claims.

• Strong conceptual and analytical thinking skills.

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

• Capacity to manage work-related stress effectively.

• Ability to juggle multiple priorities at once.

• Proven ability to meet deadlines.

• Proficient computer keyboarding skills.

• Capability for hearing, vision, and speech.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunity to operate in an agile environment.

• Career development and promotional opportunities.

• Medical, dental, and vision insurance coverage.

• 401K available from day one.

• 401K matching benefits.

• Paid Time Off (PTO).

• Disability insurance.

• Life insurance.

• Employee assistance programs.

• Flexible spending or health savings accounts.

• Additional voluntary benefits available.