Hybrid Workers’ Comp Claims Examiner II (Complex Cases)

Tristar Insurance; Kapolei (HI); Hybrid; USD 70,000 - 85,000; Full time

Benefits offered by this job

Medical, Dental, Vision, Disability &

401(k) plan

Paid time off

Paid holidays

Job summary

Tristar Insurance in Honolulu—Kapolei, HI is seeking an experienced Claims Administrator to manage a large workers’ compensation caseload. The hybrid role supports indemnity and future medical claims from inception to conclusion under established guidelines.

You will collaborate with clients, claimants, medical providers, and vendors, applying state laws and company policies while maintaining thorough documentation and timely communication.

Qualifications

• Bachelor’s degree in a related field preferred; 3+ years of related claims experience.
• Experience with workers’ compensation claims and medical billing.
• Strong written and verbal communication abilities.

Responsibilities

• Manage a caseload of 130–150 workers’ compensation files.
• Investigate claims and determine compensability.
• Administer benefits per state laws and company guidelines.
• Manage medical treatment and billing; authorize as appropriate.
• Coordinate with defense counsel and vendors.

Skills

Analytical skills

Communication skills

Medical terminology

Regulatory knowledge

MS Word & Excel

Education

Bachelor’s degree (preferred)

Tools

MS Word

Excel

Job description

Tristar Insurance in Honolulu—Kapolei, HI is seeking an experienced Claims Administrator to manage a large workers’ compensation caseload. The hybrid role supports indemnity and future medical claims from inception to conclusion under established guidelines.

You will collaborate with clients, claimants, medical providers, and vendors, applying state laws and company policies while maintaining thorough documentation and timely communication.