Medical Only Examiner, Workers' Compensation

Gallagher; Oregon; Hybrid; Confidential; Full time

Benefits offered by this job

Competitive compensation

Comprehensive benefits programs

Career development opportunities

People-first culture

Global reach with local impact

Job summary

Gallagher, a global leader in risk management and consulting, is seeking a Medical Only Claims Examiner to join our Workers' Compensation Claims team. This is a remote position based in California, requiring a detail-oriented, customer-focused approach and strong claims processing experience.

You will administer Medical Only workers' compensation claims, ensure timely processing, maintain accurate records, and deliver exceptional service to clients and injured workers while adhering to

Qualifications

• Bachelor's degree required.
• 3+ years claim handling experience in a brokerage or insurance industry.

Responsibilities

• Process and administer Medical Only workers' compensation claims according to policies.
• Perform data entry and establish all new Medical Only claims.
• Conduct claim investigations and verify injury details, compensability, and status.
• Review notices, correspondence, and required documentation.
• Calculate mileage reimbursements and other applicable benefits.
• Verify lost time, waiting periods, and eligibility.
• Monitor and manage modified duty programs.
• Maintain claim notes and timely diary entries.
• Identify claims needing escalation or conversion to Indemnity status with documentation.

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.

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'll 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 escalating 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

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)