Senior Claims Examiner

Athens Administrators; California (MO); Hybrid; USD 10,000 - 60,000; Full time

Job summary

An established industry player is seeking a Senior Claims Examiner to support workers' compensation claims across California. This full-time role offers a hybrid work model, allowing flexibility based on proximity to offices. You will manage claims from inception to closure, ensuring timely processing and effective negotiation of settlements. The ideal candidate will have a strong background in workers' compensation laws and excellent communication skills. Join a family-owned company that values professional growth and offers a collaborative environment where your contributions will make a significant impact.

Benefits

Competitive Pay

Benefits Package

Opportunities for Salary Adjustments

Qualifications

• 3+ years experience in workers' compensation claims handling.
• Knowledge of workers' compensation laws and procedures is essential.

Responsibilities

• Manage claims from inception to closure, ensuring timely processing.
• Investigate claims, negotiate settlements, and prepare reports.

Skills

Workers' Compensation Laws

Medical/Legal Terminology

Negotiation Skills

Communication Skills

Organizational Skills

Problem-Solving Skills

Analytical Skills

Education

High School Diploma or GED

AA/AS or BA/BS

Administrators Certificate from Self-Insurance Plans

Tools

Microsoft Office

Job description

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Athens Administrators provided pay range

This range is provided by Athens Administrators. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$49.00/hr - $55.00/hr

Position Details

Position Title: Senior Claims Examiner

Department: Workers’ Compensation California

Reports To: Claims Supervisor

FLSA Status: Non-Exempt

Job Grade: 12

Career Ladder: Next step could include Lead Senior Claims Examiner or Claims Supervisor

About Athens Administrators

Since 1976, Athens Administrators has been a leader in claims administration, fostering an engaging and inclusive culture. We offer opportunities for professional growth in Workers' Compensation, Property & Casualty, and more. Join our nationwide family-owned company and make an impact!

Position Summary

This full-time role supports workers' compensation claims across California, with a hybrid work model based on proximity to our offices in Concord or Orange. The Senior Claims Examiner manages claims from inception to closure, ensuring timely processing, managing medical treatment, setting reserves, and negotiating settlements.

Primary Responsibilities

Responsibilities include establishing contact with employers, responding to inquiries, reviewing legal and medical reports, evaluating medical procedures, administering benefits, investigating claims, reviewing bills, discussing medical treatments, determining claim compensability, monitoring litigation, negotiating settlements, preparing reports, closing claims, and supporting clients and team members.

Essential Requirements

• High School Diploma or GED required; AA/AS or BA/BS preferred
• Administrators Certificate from Self-Insurance Plans within one year
• Current Experienced Indemnity Claims Adjuster Designation (California)
• 3+ years recent workers' compensation claims handling experience; 5+ years preferred
• Knowledge of workers' compensation laws, policies, procedures
• Proficiency in medical/legal terminology, Microsoft Office, and negotiation skills
• Strong communication, organizational, problem-solving, and analytical skills
• Ability to handle confidential information with integrity
• Ability to attend occasional in-office meetings

Application Process

Apply through our website at our careers page. Submit your resume and cover letter. We consider applicants with arrest or conviction records in accordance with applicable laws.

Equal Opportunity Statement

We are an Equal Opportunity employer, committed to diversity and inclusion in the workplace.

Additional Information

We offer competitive pay, benefits, and opportunities for salary adjustments. Learn more about our benefits at our benefits page.