Workers Compensation Claims Examiner – CA or NV License Required

This is a fully remote position, open to applicants in California, +2 more states.

📋 Description

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

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

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

• Conduct investigations and gather necessary information to assess claim exposure.

• Negotiate claim settlements within the specified authority.

• Relay claim activity and processing details to claimants and clients.

• Report claims to the excess carrier.

• Address 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.

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

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

• Must possess a valid license in California or Nevada.

• Ability to analyze and process workers' compensation claims effectively.

• Capability to investigate and gather information to evaluate claim exposure.

• Proficiency in negotiating claim settlements within designated authority.

• Skill in communicating claim activity and processing with both claimants and clients.

• Competence in reporting claims to excess carriers and responding to requests for guidance.

• Strong analytical and conceptual thinking abilities.

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

• Ability to manage work-related stress and prioritize multiple tasks simultaneously.

• Capability to meet deadlines consistently.

• Proficient computer keyboarding skills.

• Adequate hearing, vision, and verbal communication abilities.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunities for career development and promotional growth.

• Medical, dental, and vision coverage.

• 401K available from day one.

• 401K matching program.

• Paid Time Off (PTO).

• Disability insurance.

• Life insurance.

• Employee assistance program.

• Flexible spending or health savings accounts.

• Additional voluntary benefits available.