Senior Workers' Compensation Claims Examiner

TEEMA; Houston (TX); On-site; USD 70,000 - 100,000; Full time

Job summary

TEEMA is seeking an experienced Workers’ Compensation Claims Examiner to join a collaborative claims team in Houston. You will independently manage a caseload of 110–150 claims, with a focus on complex indemnity matters and timely resolutions.

You will coordinate with claimants, employers, medical providers, and attorneys, applying strong investigative skills and sound judgment to ensure compliance with Texas regulations and company guidelines.

Qualifications

• 5+ years of workers’ compensation claims handling experience, including complex indemnity claims.
• Strong understanding of workers’ compensation statutes, medical terminology, and claims investigation.
• Excellent written and verbal communication skills.
• Ability to manage a high-volume caseload independently.
• Proficiency with Microsoft Office applications preferred.

Responsibilities

• Investigate and manage workers’ compensation claims from inception to closure.
• Determine compensability and administer benefits in accordance with state laws and company guidelines.
• Coordinate medical treatment and manage related billing activity.
• Establish and maintain accurate claim reserves.
• Maintain organized documentation and diary management for all claim activity.
• Communicate effectively with clients regarding claim status, trends, and risk concerns.
• Conduct independent file reviews and proactively drive claims toward resolution.

Skills

Claims investigation

Communication skills

High-volume caseload management

Analytical thinking

Microsoft Office

Tools

Microsoft Office

Job description

TEEMA is seeking an experienced Workers’ Compensation Claims Examiner to join a collaborative claims team in Houston. You will independently manage a caseload of 110–150 claims, with a focus on complex indemnity matters and timely resolutions.

You will coordinate with claimants, employers, medical providers, and attorneys, applying strong investigative skills and sound judgment to ensure compliance with Texas regulations and company guidelines.