Senior Workers' Comp Claims Examiner — Remote

ATHENS ADMINISTRATORS; Concord (CA); Hybrid; USD 70,000 - 95,000; Full time

Job summary

Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers' compensation offices and can be located anywhere in California, with in-office work once weekly for those near Concord or Orange.

The role involves adjusting claims from inception through settlement, setting reserves, directing medical treatment, negotiating settlements, and preparing client reports. CA regulations, communication, and analytical skills are essential.

Qualifications

• 3+ years recent workers' compensation claims handling experience.
• At least 5 years of workers' comp claims experience preferred.
• Solid knowledge of workers' compensation laws, policies, and procedures.
• Completion of IEA or equivalent courses.
• Proficiency in determining case value and negotiating settlements.
• Strong verbal and written communication skills.

Responsibilities

• Establish contact with employer to review issues.
• Respond to inquiries from employer, employee, doctors and attorneys.
• Establish and maintain appropriate reserves.
• Review medical and legal reports and approvals.
• Negotiate settlements and authorize medical costs.
• Prepare and present reports to clients and close claims.

Skills

Claims adjusting

Negotiation

Medical management

Legal terminology

Communication skills

Analytical skills

Attention to detail

Team mentoring

Education

High school diploma

AA/AS preferred

Administrators Certificate

Experienced Indemnity Claims Adjuster

Tools

Microsoft Office

Job description

Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers' compensation offices and can be located anywhere in California, with in-office work once weekly for those near Concord or Orange.

The role involves adjusting claims from inception through settlement, setting reserves, directing medical treatment, negotiating settlements, and preparing client reports. CA regulations, communication, and analytical skills are essential.