Claims Examiner - Workers Compensation | Jurisdiction: CA or NV | Licensing: required
About the role
Our client operates globally in the claims management industry, serving clients across various sectors. The organization addresses the challenges clients face in managing complex claims by providing expert adjudication and innovative solutions. With a large workforce and a broad network of professionals, the organization emphasizes excellence in customer service and professional growth.
The Claims Examiner – Workers Compensation is responsible for analyzing and adjudicating workers compensation claims within California or Nevada jurisdictions. This role ensures claims are processed accurately and timely, determining benefits due while meeting service standards and client‑specific requirements. The position directly impacts client satisfaction and claims resolution efficiency.
Responsibilities
- Analyze and process claims using established action plans to reach appropriate resolutions.
- Investigate and gather information to assess claim exposure.
- Negotiate claim settlements within authorized limits.
- Communicate claim status and activities with claimants and clients.
- Report claims to excess carriers and respond to their inquiries professionally and promptly.
Requirements
- High School Diploma or GED required; Bachelor’s degree preferred.
- Professional certification relevant to the line of business preferred.
- Minimum of 5 years claims management experience or equivalent education and experience.
- Must hold a valid license for California or Nevada jurisdictions.
Pay
The starting pay range for this role is $80,000 to $100,000.
Benefits
- Medical, dental, and vision coverage.
- 401(k) with matching contributions.
- Paid time off.
- Disability and life insurance.
- Employee assistance programs.
- Flexible spending or health savings accounts.
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.