Claims Examiner – Workers Compensation

This is a fully remote position, open to applicants in Florida, +3 more states.

📋 Description

• Evaluate and manage Workers Compensation claims through strategic action plans to ensure timely and appropriate resolutions.

• Investigate claims thoroughly and collect relevant information to assess exposure.

• Negotiate settlements for claims within assigned authority limits.

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

• Report claims to the excess carrier and address inquiries for guidance.

• Ensure continuous adjudication of claims in alignment with service expectations, industry best practices, and client service standards.

⛳️ Requirements

• High School Diploma or GED is mandatory.

• A Bachelor's degree from an accredited institution is preferred.

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

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

• Licensing in Florida or home state is necessary.

• Familiarity with the jurisdictions of Southeast States is essential.

• Proficient ability to analyze, investigate, and compile information to evaluate claim exposure.

• Competence in negotiating claim settlements within the designated authority.

• Effective communication skills regarding claim activities and processing with claimants and clients.

• Ability to report claims to the excess carrier and respond to directional requests.

• Strong conceptual and critical thinking skills.

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

• Capability to manage work-related stress and handle multiple priorities simultaneously.

• Aptitude for meeting deadlines consistently.

• Proficient keyboarding skills.

• Willingness to travel as needed.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunities for career development and advancement.

• Comprehensive medical, dental, and vision coverage.

• 401K eligibility starting on day one.

• 401K matching program.

• Paid Time Off (PTO).

• Disability and life insurance options.

• Employee assistance programs.

• Flexible spending or health savings accounts.

• Additional voluntary benefits available.