Senior Workers' Comp Claims Examiner (Remote)

Athens Administrators; South Gate (CA); Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Medical plan

Vision plan

Dental plan

Life and AD&D

401k (and Roth)

STD & LTD

Job summary

Athens Administrators is seeking a full-time Senior Claims Examiner to support workers' compensation offices statewide in California. Some in-office days required for those living within 26 miles of Concord or Orange offices; remaining days may be remote with supervisor-approved scheduling. Office hours are 7:30 a.m.

to 5:30 p.m. Monday–Friday, 37.5 hours/wk with possible flex scheduling. The role involves adjusting claims from inception through settlement, managing medical treatment, setting

Qualifications

• High School Diploma or equivalent (GED) required for all positions.
• AA/AS or BA/BS preferred but not required.
• Administrators Certificate from Self-Insurance Plans within one year of employment if not already obtained.
• 3+ years recent workers' compensation claims handling experience required.
• At least 5 years of workers' compensation claims experience preferred.
• Proficiency in determining case value and negotiating settlements.
• Understanding of medical and legal terminology.
• Ability to type quickly and accurately; proficient in Microsoft Office.

Responsibilities

• Establish contact with employer to review issues.
• Respond to inquiries from the employer, employee, doctors, and attorneys.
• Establish and maintain appropriate reserves.
• Review legal correspondence and medical reports.
• Evaluate and approve medical procedures and treatment.
• Administer benefits and ensure appropriateness of all payments.
• Investigate coverage, liability, and monetary value of claim.
• Negotiate settlements and monitor litigation.
• Prepare and present reports to clients.
• Close claims and resolve client inquiries.

Skills

Communication

Organization

Analytical skills

Attention to detail

Teamwork

MS Office

Education

High School Diploma or GED

AA/AS or BA/BS preferred

Tools

Microsoft Office Suite

Job description

Athens Administrators is seeking a full-time Senior Claims Examiner to support workers' compensation offices statewide in California. Some in-office days required for those living within 26 miles of Concord or Orange offices; remaining days may be remote with supervisor-approved scheduling. Office hours are 7:30 a.m.

to 5:30 p.m. Monday–Friday, 37.5 hours/wk with possible flex scheduling. The role involves adjusting claims from inception through settlement, managing medical treatment, setting