Advanced Workers' Comp Indemnity Examiner

TEEMA Group

Irving (TX)

On-site

USD 70,000 - 75,000

Full time

4 days ago
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Job summary

TEEMA Group is seeking an experienced Workers’ Compensation Indemnity Claims Examiner II in Irving, TX. This on-site role handles a large caseload of indemnity claims, requiring solid knowledge of workers’ compensation statutes and strong judgment for settlements and reserves.

You will evaluate medical documentation, maintain compliance with deadlines, and escalate high-exposure issues as needed. Collaboration with supervisors and counsel is essential in complex matters.

Qualifications

  • 3–5 years of related claims experience.
  • Experience directly managing workers’ compensation indemnity claims, including moderate to complex and litigated files.
  • Technical knowledge of applicable workers’ compensation statutes, regulations, and medical terminology.
  • Strong analytical skills and the ability to make independent claims handling decisions within assigned authority.
  • Ability to prioritize a substantial caseload and recognize matters requiring supervisory review.
  • Excellent written and verbal communication skills.
  • Ability to work professionally with individuals at all levels of the business.
  • Any license or certification required by applicable state regulations.

Responsibilities

  • Manage a caseload of approximately 150-180 workers’ compensation indemnity claims.
  • Evaluate claim information, medical documentation, and applicable statutory requirements to guide claims handling decisions.
  • Calculate, establish, and adjust reserves based on claim exposure.
  • Authorize payments and settlements within assigned authority and company and client guidelines.
  • Identify and escalated significant exposure, unusual compensability issues, sensitive client concerns, and decisions exceeding authority.
  • Refer claims to defense counsel as appropriate and monitor litigation activities.
  • Consult with your supervisor on significant legal developments and settlement strategy.
  • Communicate claim status and technical information clearly to claimants, clients, counsel, and internal staff.
  • Maintain accurate claim documentation and meet applicable deadlines and client handling requirements.

Skills

Indemnity claims handling
Analytical skills
Independent decision making
Communication skills
Caseload management
WC claims knowledge
Licenses/Certifications

Education

Bachelor's degree

Tools

Microsoft Word
Excel

Job description

TEEMA Group is seeking an experienced Workers’ Compensation Indemnity Claims Examiner II in Irving, TX. This on-site role handles a large caseload of indemnity claims, requiring solid knowledge of workers’ compensation statutes and strong judgment for settlements and reserves.

You will evaluate medical documentation, maintain compliance with deadlines, and escalate high-exposure issues as needed. Collaboration with supervisors and counsel is essential in complex matters.

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