Senior Workers’ Comp Claims Examiner

Amergis Healthcare Staffing; Columbia (MD); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Medical/Prescription

Dental

Vision

401(k) Company Match

Paid Time Off

Job summary

Amergis Healthcare Staffing is seeking a Claims Examiner in the Workers’ Compensation domain to manage full cycle claim processes and resolve claims across assigned states. You will collaborate with local offices, TPAs, and providers to communicate status plans and ensure deadlines are met.

The role requires 5–10 years WC experience, strong organizational skills, and proficient use of Microsoft Office. You will work independently within a team, providing excellent customer service to injured

Qualifications

• College degree preferred; or equivalent work experience.
• 5 to 10 years of Workers’ Compensation experience preferred
• Some legal experience strongly preferred
• Good organizational skills and attention to detail
• Ability to work independently and cooperatively in a team environment
• Ability to communicate effectively and provide excellent customer service with individuals at all levels of the organization
• Computer proficiency, including Microsoft Office applications, required
• Prior experience performing internet research
• Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills; proficiency in the English language is required

Responsibilities

• Manages full cycle claim management for assigned states to resolution
• Participates in conference calls with local offices, third-party administrators (TPAs), medical providers, and other Amergis employees in order to communicate status plans
• Ensures legal deadlines are met
• Monitors TPA’s file resolution plans
• Represents Amergis in depositions, mediation, and conference calls regarding assigned claim files
• Provides analysis on the financial aspects of assigned claims files
• Provides excellent customer service to injured workers
• Prepares WC claim reports for department management team
• Reviews, identifies and makes recommendations for maintaining control and/or reducing the claims experience (loss history) of the company
• Authorizes or revise reserve requests
• Coordinates with Benefits team during employee’s absence
• Coordinates with state programs and internal departments for transitional duty
• Educates branch offices about all aspects of Workers’ Compensation
• Assists Manager in achieving overall department goals
• Performs other duties as assigned/necessary

Skills

Strong communication

Organizational skills

Team player

English proficiency

Independent worker

Education

College degree preferred or equivalent

Tools

Microsoft Office

Job description

Amergis Healthcare Staffing is seeking a Claims Examiner in the Workers’ Compensation domain to manage full cycle claim processes and resolve claims across assigned states. You will collaborate with local offices, TPAs, and providers to communicate status plans and ensure deadlines are met.

The role requires 5–10 years WC experience, strong organizational skills, and proficient use of Microsoft Office. You will work independently within a team, providing excellent customer service to injured