Claims Examiner – Workers’ Comp & Investigations

GeorgiaTEK Systems Inc.; New Haven (CT); On-site; USD 55,000 - 75,000; Full time

Job summary

GeorgiaTEK Systems Inc. seeks a qualified Claims Examiner to manage workers’ compensation claims from initiation to closure in a fast-paced, customer-focused environment.

You will review claims, conduct multi-party investigations, assess compensability, and communicate outcomes to insureds and attorneys. The role requires strong organizational skills, knowledge of regulatory requirements, and collaboration with internal teams.

Qualifications

• Experience in a fast-paced, customer-focused environment.
• Strong communication and telephonic skills.
• High level of organization and accountability.
• Knowledge of workers’ compensation claims handling is a plus.
• Experience with claim handling across healthcare, disability, auto PIP, or liability is a plus.

Responsibilities

• Handle all aspects of workers’ compensation claims from setup to closure.
• Review claim and policy information to support investigation.
• Conduct 3-part investigations with insured, claimant, and medical providers.
• Determine compensability and communicate denials when applicable.
• Prepare investigative reports and monitor medical/indemnity benefits.
• Set reserves within authority and advise on changes to Team Leader.
• Coordinate with attorneys, vendors, and case managers to manage hearings and litigation.
• Ensure compliance with statutory regulations and subrogation opportunities.

Skills

Customer focus

Communication

Organization

Accountability

Time management

Analytical thinking

Education

Licenses: CT/ NH/ RI/ VT Claim Adjuster

Tools

Microsoft Office

Job description

GeorgiaTEK Systems Inc. seeks a qualified Claims Examiner to manage workers’ compensation claims from initiation to closure in a fast-paced, customer-focused environment.

You will review claims, conduct multi-party investigations, assess compensability, and communicate outcomes to insureds and attorneys. The role requires strong organizational skills, knowledge of regulatory requirements, and collaboration with internal teams.