Workers Compensation Claims Examiner

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Evaluate Medical Only and Lost-Time Workers Compensation claims for clients to ascertain due benefits.

• Maintain ongoing claim adjudication in alignment with service expectations, industry standards, and specific client requirements.

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

• Investigate and collect information to assess claim exposure.

• Negotiate claim settlements within assigned authority limits.

• Communicate updates on claims processing to claimants and clients.

• Notify the excess carrier of claims.

• Respond to inquiries for direction promptly and professionally.

⛳️ Requirements

• High School Diploma or GED is mandatory.

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

• Relevant professional certification for the line of business is preferred.

• A minimum of 2 years of claims management experience or an equivalent combination of education and experience is required.

• Knowledge of jurisdictional laws in NJ, PA, VA, and MA.

• Strong analytical and conceptual thinking skills.

• Excellent judgment, problem-solving, troubleshooting, and discretion.

• Capability to manage work-related stress effectively.

• Ability to juggle multiple priorities concurrently.

• Proficient in meeting deadlines.

• Computer keyboarding skills.

• Adequate hearing, vision, and verbal communication abilities.

🏝️ Benefits

• Flexible work schedule.

• Incentive program for referrals.

• Opportunities for career development and advancement.

• Comprehensive medical, dental, and vision coverage.

• 401K plan with matching contributions.

• Paid Time Off (PTO).

• Disability and life insurance options.

• Employee assistance programs.

• Flexible spending or health savings accounts.

• Additional voluntary benefits available.

• Reasonable accommodations provided when applicable and appropriate.