Medical Only Examiner, Workers' Compensation

Gallagher; Corona (CA); Remote; Confidential; Full time

Benefits offered by this job

Competitive pay

Benefits package

Career development

People-first culture

Global reach local impact

Job summary

Gallagher is hiring a Medical Only Claims Examiner in California. The role focuses on administering Medical Only workers' compensation claims with emphasis on accuracy, regulatory compliance, and excellent client service.

Remote work within California with opportunities for growth and impact. The candidate will handle timely processing, benefits administration, and documentation while collaborating with a team committed to integrity and client trust.

Qualifications

• Bachelor's degree required.
• Minimum of 3 years claim handling experience in brokerage or insurance.
• California IEA class course completion preferred.

Responsibilities

• Process and administer Medical Only workers' compensation claims.
• Perform data entry and establish all new Medical Only claims.
• Conduct claim investigations and verify injury details and status.
• Review DWC notices, correspondence, and required documentation.
• Calculate and issue mileage reimbursements and other benefits.
• Verify lost time and eligibility requirements.
• Monitor modified duty programs and diary closeouts.
• Maintain accurate claim notes and records.
• Escalate or convert to Indemnity status with supporting docs.
• Refer imaging requests for utilization review as required.
• Process medical bills promptly to ensure compliance.
• Review reserve levels and update financial exposure.
• Investigate questionable claims and escalate when needed.
• Maintain high-quality claim closure and service standards.
• Return calls and respond to inquiries within service standards.
• Review daily mail and electronic documents in a paperless environment.

Skills

Claim handling

Customer service

Attention to detail

Education

Bachelor's degree

Job description

Introduction

At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they're free to grow, lead, and innovate. You'll be backed by our digital ecosystem: a client-centric suite of consulting tools making it easier for you to meet your clients where they want to be met. Advanced data and analytics providing a comprehensive overview of the risk landscape is at your fingertips. Here, you're not just improving clients' risk profiles, you're building trust. You'll find a culture grounded in teamwork, guided by integrity, and fueled by a shared commitment to do the right thing. We value curiosity, celebrate new ideas, and empower you to take ownership of your career while making a meaningful impact for the businesses we serve. If you're ready to bring your unique perspective to a place where your work truly matters; think of Gallagher.

At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they're free to grow, lead, and innovate. You'll be backed by our digital ecosystem: a client-centric suite of consulting tools making it easier for you to meet your clients where they want to be met. Advanced data and analytics providing a comprehensive overview of the risk landscape is at your fingertips. Here, you're not just improving clients' risk profiles, you're building trust. You'll find a culture grounded in teamwork, guided by integrity, and fueled by a shared commitment to do the right thing. We value curiosity, celebrate new ideas, and empower you to take ownership of your career while making a meaningful impact for the businesses we serve. If you're ready to bring your unique perspective to a place where your work truly matters; think of Gallagher.

Overview

This is a remote position based in California, and candidates must reside within the state. Keenan, now a part of Gallagher, is seeking a detail-oriented and customer-focused Medical Only Claims Examiner to join our Workers' Compensation Claims team. In this role, you will be responsible for administering Medical Only workers' compensation claims, ensuring timely claim processing, accurate benefit administration, regulatory compliance, and outstanding service to clients and injured workers. As part of Gallagher, a global leader in insurance, risk management, and consulting, you will be joining a team that’s passionate about helping individuals and organizations thrive. This is an excellent opportunity for a claims professional who values accuracy, organization, and providing exceptional support throughout the claims process.

How You'll Make An Impact

• Process and administer Medical Only workers' compensation claims in accordance with company policies and procedures.
• Perform data entry and establish all new Medical Only claims.
• Conduct claim investigations, including three-point contact when necessary, to verify injury details, compensability, and claim status.
• Review and process DWC notices, correspondence, and required documentation.
• Calculate and issue mileage reimbursements and other applicable benefits.
• Verify lost time, waiting periods, and eligibility requirements.
• Monitor and manage modified duty programs.
• Maintain accurate claim notes and timely diary management.
• Identify claims requiring escalation or conversion to Indemnity status and provide supporting documentation.
• Refer diagnostic services and imaging requests for utilization review as required.
• Process medical bills promptly to ensure compliance and avoid penalties or interest charges.
• Review reserve levels and update financial exposure as claim information changes.
• Investigate questionable claim circumstances and elevate concerns when appropriate.
• Maintain excellent claim closure performance and quality standards.
• Return phone calls and respond to inquiries within established service standards.
• Review incoming mail and electronic documents daily in a paperless environment.
• Correct system exception reports and maintain accurate claim records.
• Deliver exceptional service and maintain positive client and claimant relationships.
• Perform other duties as assigned.

Compensation: The target salary range for this position is $50,000 to $60,000 (US Dollar) annually. The actual salary will vary based on applicant’s education, experience, skills, and abilities, as well as internal equity and alignment with market data. The salary may also be adjusted based on applicant’s geographic location.

About You

Required: Bachelor's degree and a minimum of 3 years claim handling experience in a brokerage firm or insurance industry.

Preferred: California IEA class course completion

Behaviors: Ability to multitask, communicate effectively, in writing and verbally, within all aspects of job requirements.

Compensation And Benefits

At Gallagher, we believe supporting our colleagues goes far beyond the role itself. For more information, visit our Benefits page.

• Competitive compensation
• Comprehensive benefits programs designed to support your well-being
• Career development opportunities and ongoing learning
• A collaborative, people-first culture with accessible leadership
• The opportunity to do meaningful work with global reach and local impact

At Gallagher, we are dedicated to building an inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to join our Talent Community to stay connected to additional career opportunities. At times, we will consider transferable skills from previous roles.

Gallagher is an affirmative action/equal opportunity employer (Minorities/Females/Veterans/Disabled)