Claims Examiner – Workers Compensation, Jurisdiction & Licensing: SC & NC

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

📋 Description

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

• Ensure the continuous adjudication of claims adheres to service expectations, industry standards, and client service protocols.

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

• Investigate and collect information to assess claim exposure.

• Negotiate claim settlements within the established authority limits.

• Communicate claim processing and activity updates with claimants and clients.

• Report claims to the excess carrier as required.

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

⛳️ Requirements

• High School Diploma or GED is mandatory.

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

• Relevant professional certification applicable to the line of business is preferred.

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

• Familiarity with SC and NC jurisdictions and licensing is necessary.

• Strong analytical and conceptual thinking abilities.

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

• Capability to manage work-related stress effectively.

• Ability to juggle multiple priorities simultaneously.

• Competence in meeting deadlines.

• Proficient keyboarding skills.

• Willingness to travel as necessary.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunities for career development and promotional growth.

• A diverse and comprehensive benefits package including medical, dental, vision, and 401K from day one.

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

• Opportunities for professional development.