Hybrid WC Claims Examiner – Resolve Workers’ Comp Claims

Maxim Healthcare; Columbia (MD); Hybrid; USD 28,000 - 33,000; Full time

Benefits offered by this job

Health and Wellness benefits

401(k) + Company Match

Paid Time Off

Holidays

Educational Assistance Program

Employee Discount Program

Dental

Vision

Health Advocacy Program

Life Insurance

Pet Insurance

Job summary

Maxim Healthcare in Columbia, MD, is seeking a WC Claims Examiner I to manage workers' compensation claims from intake to resolution. You will work with TPAs, medical providers, attorneys, and colleagues to implement claim handling plans and ensure timely action.

You will monitor files, meet legal deadlines, discuss reserves and settlements with the WC Manager, and contribute to process improvements while delivering excellent customer service to employees.

Qualifications

• Bachelor's degree in business, human resources, or related field preferred.
• At least 3 years of claims handling experience or legal assistance experience supporting claims.
• Legal experience strongly preferred.
• Good organizational skills and attention to detail.

Responsibilities

• Brings pending and new WC claims to resolution.
• Participates in calls with TPAs, medical providers, attorneys, and Maxim team members to agree on plans.
• Monitors TPA files.
• Ensures legal deadlines are met.
• Maintains WC Department Legal Calendar.
• Participates in depositions, mediations, and calls regarding assigned claim files.
• Reviews and comments on the financial aspects of assigned claim files.
• Educates branch offices about workers compensation.
• Provide excellent customer service to all employees.
• Helps identify patterns developing from injuries and resulting in WC claims.
• Helps to track claims and run reports for management.
• Makes recommendations for improving the WC claim process reducing overall claim counts.
• Performs other duties as assigned

Skills

Organizational skills

Independent worker

Customer service

Communication skills

Team player

Education

Bachelor's degree preferred

Tools

Microsoft Office

Job description

Maxim Healthcare in Columbia, MD, is seeking a WC Claims Examiner I to manage workers' compensation claims from intake to resolution. You will work with TPAs, medical providers, attorneys, and colleagues to implement claim handling plans and ensure timely action.

You will monitor files, meet legal deadlines, discuss reserves and settlements with the WC Manager, and contribute to process improvements while delivering excellent customer service to employees.