Claims Examiner – Workers Compensation

This is a fully remote position, open to applicants in Illinois, +1 more state.

📋 Description

• Evaluate Workers Compensation claims on behalf of clients to ascertain the benefits owed.

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

• Analyze and manage claims through action plans to achieve timely resolutions.

• Investigate and collect information to assess claim exposure.

• Negotiate the settlement of claims within the assigned authority.

• Effectively communicate claim activities and processing updates to claimants and clients.

• Report claims to the excess carrier.

• Promptly and professionally respond to requests for guidance.

⛳️ 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 experience in claims management or an equivalent combination of education and experience is required.

• Familiarity with the jurisdiction of Midwest states is necessary.

• Licensing in MI or MN is required.

• Capability to analyze and process workers compensation claims.

• Proficiency in investigating and gathering information to evaluate claim exposure.

• Ability to negotiate claim settlements within the designated authority.

• Skill in communicating claim activities and processing with claimants and clients.

• Competence in reporting claims to the excess carrier and addressing requests for directions.

• Strong clear and conceptual thinking abilities.

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

• Ability to manage work-related stress and multiple priorities concurrently.

• Capacity to meet established deadlines.

• Proficient keyboarding skills.

• Willingness to travel as necessary.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunity to thrive in an agile environment.

• Career development and promotional growth prospects.

• Coverage for medical, dental, and vision.

• 401K available from day one.

• 401K matching.

• Paid Time Off (PTO).

• Disability and life insurance.

• Employee assistance programs.

• Flexible spending or health savings accounts.

• Additional voluntary benefits available.