Workers Compensation Claims Examiner

Key Responsibilities

• Investigate and manage workers’ compensation claims from inception to closure
• Determine compensability and administer benefits in accordance with state laws and company guidelines
• Cook up medical treatment and manage related billing activity
• Establish and maintain accurate claim reserves
• Maintain organized documentation and diary management for all claim activity
• Communicate effectively with clients regarding claim status, trends, and risk concerns
• Conduct independent file reviews and proactively drive claims toward resolution

Qualifications

• Active Texas Workers’ Compensation Adjuster License required
• 5+ years of workers’ compensation claims handling experience, including complex indemnity claims
• Strong understanding of workers’ compensation statutes, medical terminology, and claims investigation
• Excellent written and verbal communication skills
• Ability to manage a high-volume caseload independently
• Proficiency with Microsoft Office applications preferred