We are seeking a detail-oriented, proactive, critical thinker to manage and review workers' comp claims as a Claims Examiner.
As a Claims Examiner, your duties will include investigating and processing insurance claims, negotiating settlements, and maintaining accurate claims records.
The ideal candidate should have a strong understanding of worker's compensation policies and regulations, excellent investigative skills, and exceptional customer service skills. If you have no prior experience with these policies and regulations, you must be willing to learn and be responsible for implementing claims based on these policies and regulations.
Responsibilities:
Learn/understand worker's compensation policies and regulations.
Review workers' compensation claim forms.
Assists claimants as needed in relating their claim.
Assists management with more complex cases.
Maintains accurate records and prepares required reports on all cases.
Performs other related duties as assigned.
Ensure employees' Workers Compensation claims are reviewed and approved by Claims Examiners promptly
Ensure Claim forms are accurately completed
Identify accurate code for injury or illness based on the claim form and enter it into the claims system
Maintain worker's compensation claim log
Data entry into Worker's Compensation system
Qualifications:
Required:
Active/current TS/SCI with Polygraph is required.
Bachelor's degree or equivalent and 5+ years of relevant experience.
Excellent communication skills.
Excellent organizational skills and attention to detail.
Excellent negotiation skills.
Ability to work with and to preserve confidential material.
Proficient with Microsoft Office Suite or similar software.
Ability to work as a member of a team.
Extensive experience in customer service.
Desired:
Knowledge of quantitative and qualitative research methods.