Workers Compensation Claims Examiner II

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

📋 Description

• Efficiently oversees a caseload of 150 or fewer workers’ compensation claims.

• Promptly initiates and conducts investigations.

• Assesses the compensability of claims and administers benefits in accordance with state law.

• Manages medical treatment and billing, authorizing as needed.

• Engages with claimants, providers, and vendors regarding claims matters.

• Calculates and establishes reserves following Company guidelines.

• Maintains a diary system for case evaluations.

• Communicates relevant information swiftly to the client to ensure efficient claims resolution.

• Complies with all Company policies and procedures.

• Performs file reviews as scheduled by both the client and management.

⛳️ Requirements

• High school diploma or GED is required.

• Bachelor’s degree in a relevant field is preferred.

• Minimum of three (3) years of related experience.

• Technical expertise in statutory regulations and medical terminology.

• Strong analytical skills.

• Exceptional written and verbal communication abilities.

• Capability to interact with individuals at all levels within the business environment.

• Ability to manage fairly complex claims independently and effectively.

• Proficiency in Word and Excel is preferred.

🏝️ Benefits

• Medical, Dental, and Vision insurance.