Onsite Workers' Comp Claims Examiner (Contract)

Dhaka Technology Limited; Washington; On-site; USD 65,000 - 90,000; Full time

Job summary

Dhaka Technologies Limited Company is hiring a Workers' Compensation Claims Examiner for a District of Columbia government client. The role is onsite in an open office environment, 8:30 a.m. to 5:00 p.m.

ET, Monday through Friday. You will receive, investigate, and adjudicate workers' compensation claims, manage medical-only claims from inception to closure, and coordinate with injured workers, providers, and agency stakeholders to support timely resolution and return-to-work efforts.

Qualifications

• Bachelor's degree and two years of workers' compensation claims adjusting experience, or eight years of progressive claims handling including three years WC experience.
• Knowledge of workers' compensation laws, regulations, investigations, reserving, case management, and adjudication.
• Ability to analyze medical evidence and make claim determinations.
• Experience participating in hearings, mediations, or settlement conferences.
• Knowledge of medical terminology and treatment review.
• Strong written and verbal communication skills.
• Proficiency with Microsoft Office applications and claims management systems.
• Ability to handle confidential and sensitive information with discretion.

Responsibilities

• Receive, review, and process first reports of injury and notices of loss in accordance with laws and procedures.
• Investigate and evaluate claims to determine compensability and entitlement to benefits.
• Administer medical-only claims from inception through closure.
• Collect, analyze, and evaluate claim information and medical records.
• Review medical evidence to assess treatment necessity and return-to-work opportunities.
• Document all claim activities in the management system and communicate with stakeholders.
• Develop factual findings, analyses, and recommendations to support determinations.
• Coordinate with injured workers, providers, and agency representatives on status and plans.
• Coordinate medical appointments and follow-up care when needed.
• Draft notices and determinations; maintain complete claim files.
• Research laws and policies to support investigations.
• Manage caseloads to meet performance standards.
• Participate in reviews, mediations, hearings, and provide testimony as required.
• Provide professional customer service while safeguarding confidential information.
• Perform other duties for the Public Sector Workers' Compensation Program.

Skills

WC knowledge

Analytical thinking

Communication skills

Microsoft Office

Claims management systems

Education

Bachelor's degree or equivalent

Tools

Claims management system

Microsoft Office Suite

Job description

Dhaka Technologies Limited Company is hiring a Workers' Compensation Claims Examiner for a District of Columbia government client. The role is onsite in an open office environment, 8:30 a.m. to 5:00 p.m.

ET, Monday through Friday. You will receive, investigate, and adjudicate workers' compensation claims, manage medical-only claims from inception to closure, and coordinate with injured workers, providers, and agency stakeholders to support timely resolution and return-to-work efforts.