Workers Compensation Claims Examiner
Work at Home
Our client is looking for a Workers' Compensation Claims Examiner to join their team. The claims examiner will be responsible for administering benefits to injured workers in accordance with statutory and case law as well as pertinent regulations. The claims examiner will also oversee and delegate work to the claim assistants to ensure accurate, timely responses are made. The client is offering a competitive compensation package, benefits and a remote working schedule for candidates located in the state of Florida.
- Maintain active communication with the insured, medical professionals and legal entities.
- Direct and manage legal counsel to ensure timely and cost-effective litigation.
- Attend trials, depositions and litigation whenever able.
- Examine external claims to determine accuracy and authorize or deny payments.
- Examine claims investigated by outside adjusters, further investigating questionable claims to determine whether to authorize payments.
- Pursue subrogation, recoveries and contribution vigorously and within statutory timeframes.
- Participate in claim committee meetings, present cases and attend any other required events for claim resolution.
- Resolve claims fairly and equitable while in a timely manner to provide benefits to injured workers.
- Ensure appropriate referrals to venders to comply with cost effectiveness.
- High school diploma or GED required
- Bachelor’s degree in a related field (preferred)
- 3–6 years of experience in insurance workers' compensation claims
- WCCA or WCCP (preferred)
- State workers' compensation license in the state of employment
+1 (312) 884-0449
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