Workers Compensation Claims Examiner
Job Description
HOURS: Full-Time
DURATION: Direct Hire
WORKPLACE: Hybrid: 3 days remote and 2 days in office
PAY: $80,000 to $90,000 (depending on experience)
BENEFITS: Full comprehensive benefits package including medical, dental, vision, and PTO.
Responsibilities:
- Effectively manages an active caseload of 150 workers compensation files, including medical only, indemnity, lifetime medical and permanent partial benefit claims.
- Initiates and conducts claims investigation in a timely manner.
- Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.
- Manages medical treatment and medical billing, authorizing as appropriate.
- Communicates with claimants, providers and vendors regarding claims issues.
- Computes and set reserves within Company guidelines.
- Maintains diary system for case review and document file to reflect the status and work being performed on the file.
- Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.
- Participates in file reviews with clients, as needed.
- Other duties as assigned and including claims management of other jurisdictional workers’ comp claims.
- Bachelor's degree in a related field preferred.
- Colorado’s adjuster license is preferred.
- Minimum of 2+ years of workers' compensation claims handling experience or an equivalent combination of education and experience.
- Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff.
- Proficient in Word and Excel (preferred).
- Knowledge of self-insured claims handling (preferred).
Meet Your Recruiter
Account Manager
Since joining SDI Staffing in 2022, Nancy has demonstrated a strong aptitude for talent acquisition and client relations. She initially started as a Recruiter and has successfully transitioned into the role of an Account Manager. She has a deep passion for aiding candidates in their career journeys and takes great satisfaction in collaborating with clients to secure ideal candidates to add to their teams. Nancy's extensive knowledge in both Personal and Commercial Lines insurance, particularly with captive carriers, enables her to provide exceptional service. She works closely with clients to understand their specific needs and consistently delivers the perfect match for their offices.
In her free time, Nancy enjoys working out, trying out new restaurants, and spending time with her family.