Claims Examiner – Workers Compensation, WA & OR Cert Preferred

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

📋 Description

• Evaluate workers' compensation claims on behalf of clients to ascertain benefits owed.

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

• Analyze and process claims utilizing action plans for suitable and timely resolutions.

• Investigate and collect information to assess claim exposure.

• Negotiate claim settlements within the designated authority limits.

• Communicate claim activities and processing updates to 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 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 combination of education and experience is required.

• Knowledge of Washington and Oregon jurisdictions is essential.

• Licensing or certification from Washington and Oregon is preferred.

• Ability for clear and conceptual thinking.

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

• Capability to manage work-related stress effectively.

• Proficiency in handling multiple priorities simultaneously.

• Ability to meet deadlines consistently.

• Competence in computer keyboarding.

• Willingness to travel as needed.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunity to work in an agile environment.

• Career development and advancement opportunities.

• Medical, dental, and vision benefits available from day one.

• 401K plan with matching contributions.

• Paid Time Off (PTO).

• Disability insurance.

• Life insurance.

• Employee assistance program.

• Flexible spending account or health savings account options.

• Additional voluntary benefits available.

• Reasonable accommodations provided when applicable and appropriate.