Hybrid Workers’ Compensation Claims Examiner III

TEEMA Solutions Group; Albuquerque (NM); Hybrid; USD 80,000 - 90,000; Full time

Job summary

TEEMA Solutions Group seeks a Workers’ Compensation Claims Examiner III in Albuquerque with 2+ years of claims experience and strong knowledge of New Mexico statutes. The role involves an active caseload and independent judgment on compensability decisions, with a path to hybrid work after training.

Responsibilities include managing medical treatment and billing, setting reserves, and maintaining meticulous file documentation while coordinating with claimants, providers, and clients.

Qualifications

• 2+ years of Workers’ Compensation claims experience.
• Working knowledge of New Mexico Workers’ Compensation statutes and benefit administration.
• Ability to manage an active caseload independently and apply strong judgment to compensability decisions.
• Excellent analytical, written, verbal, and customer-service skills.
• Microsoft Word and Excel proficiency preferred.

Responsibilities

• Investigate claims, determine compensability, and administer benefits in accordance with New Mexico law and company guidelines.
• Manage medical treatment, authorizations, and medical billing.
• Establish and maintain appropriate reserves within assigned authority.
• Maintain accurate, timely file documentation and diary activity.
• Communicate clearly with claimants, medical providers, vendors, clients, and internal partners.
• Identify and report injury trends or safety-related concerns to clients.
• Participate in client file reviews and handle claims in other jurisdictions as assigned.

Skills

Analytical

Communication

Judgment

Customer Service

Education

High school diploma or GED

Bachelor’s degree preferred

Tools

Microsoft Word

Excel

Job description

TEEMA Solutions Group seeks a Workers’ Compensation Claims Examiner III in Albuquerque with 2+ years of claims experience and strong knowledge of New Mexico statutes. The role involves an active caseload and independent judgment on compensability decisions, with a path to hybrid work after training.

Responsibilities include managing medical treatment and billing, setting reserves, and maintaining meticulous file documentation while coordinating with claimants, providers, and clients.