Claims Examiner – Workers Compensation

This is a fully remote position, open to applicants in Arizona, +2 more states.

📋 Description

• Evaluate workers' compensation claims on behalf of clients to assess entitled benefits.

• Ensure continuous adjudication of claims that align with service expectations, industry standards, and client service needs.

• Analyze and manage claims through action plans aimed at achieving timely resolutions.

• Conduct investigations and gather pertinent information to assess claim exposure.

• Negotiate claim settlements within the parameters of designated authority.

• Maintain communication regarding claim activity and processing with both claimants and clients.

• Report claims to the excess carrier.

• Respond in a professional and timely manner to requests for guidance.

⛳️ Requirements

• High School Diploma or GED is mandatory.

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

• Must possess a license in California or Nevada.

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

• Professional certification relevant to the line of business is highly desirable.

• Capability to analyze and process workers' compensation claims effectively.

• Ability to investigate and collect information to evaluate claim exposure.

• Skilled in negotiating settlements within the defined authority.

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

• Proficient in managing work-related stress and juggling multiple priorities simultaneously.

• Ability to meet deadlines consistently.

• Competent in computer keyboarding.

• Capable of hearing, seeing, and speaking effectively.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunities for career development and advancement.

• Medical, dental, vision, 401K with matching contributions from day one.

• Paid time off (PTO).

• Disability and life insurance.

• Employee assistance program.

• Flexible spending or health savings account.

• Additional voluntary benefits available.

• Flexibility and autonomy in daily tasks, location, and career trajectory.

• Opportunities for professional development.