Remote Workers' Comp Claims Examiner – Texas

Canon Recruiting Group; Texas; Hybride; USD 70 000 - 90 000; Plein temps

Résumé du poste

Canon Recruiting is seeking a Workers’ Compensation Claims Examiner to manage indemnity claims of moderate to complex severity from initial assignment through resolution. The examiner will rely on knowledge of workers’ compensation regulations and exercise independent judgment.

The role involves managing about 150 claims, establishing reserves, authorizing payments and settlements, escalating complex cases, referring to defense counsel, and ensuring compliance with state regulations and client

Qualifications

• Three to five years of related claims handling experience, involving workers’ compensation indemnity claims.
• Bachelor’s degree in a related field preferred, or an equivalent combination of education and experience.
• Knowledge of workers’ compensation regulations, statutory requirements, and medical terminology.
• Ability to independently manage complex claims and exercise sound judgment within established authority limits.
• Strong analytical, organizational, written, and verbal communication skills.
• Ability to communicate technical claims information effectively to claimants, clients, and internal teams.
• Proficiency in Microsoft Word and Excel preferred.
• Required licenses or certifications in accordance with applicable state regulations.

Responsabilités

• Manage a caseload of approximately 150 workers’ compensation indemnity claims of moderate to complex difficulty.
• Establish and maintain appropriate claim reserves.
• Authorize benefit payments and settlements within assigned authority limits.
• Identify and upscale claims involving significant exposure, complex compensability issues, sensitive client concerns, or matters requiring additional authority.
• Refer claims to defense counsel when appropriate and monitor litigation throughout the claims process.
• Collaborate with supervisors regarding significant legal developments, settlement strategies, and claims requiring additional oversight.
• Ensure claims are handled in accordance with applicable state regulations, client requirements, and established procedures.
• Maintain accurate claim documentation and communicate effectively with claimants, clients, attorneys, and other stakeholders.

Connaissances

Analytical thinking

Organizational skills

Written communication

Verbal communication

Formation

Bachelor’s degree or equivalent

Outils

Microsoft Word

Microsoft Excel

Description du poste

Canon Recruiting is seeking a Workers’ Compensation Claims Examiner to manage indemnity claims of moderate to complex severity from initial assignment through resolution. The examiner will rely on knowledge of workers’ compensation regulations and exercise independent judgment.

The role involves managing about 150 claims, establishing reserves, authorizing payments and settlements, escalating complex cases, referring to defense counsel, and ensuring compliance with state regulations and client