Senior Workers' Compensation Claims Specialist | Remote

King's Insurance Staffing; New Mexico; On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Remote work option

Job summary

King's Insurance Staffing seeks a Senior Workers' Compensation Claims Examiner for New Mexico operations to manage moderate to complex Lost Time claims from inception to close across the state.

The ideal candidate holds an active New Mexico adjuster license, resides in NM, can handle a workload of 80–95 files, and will coordinate with medical providers. Remote work option and comprehensive benefits are included.

Qualifications

• 4-8+ years of Workers' Compensation Lost Time claims handling experience.
• Well-versed in New Mexico Workers’ Compensation Law.
• New Mexico Adjuster License is required.
• Must reside in the state of New Mexico.
• Excellent Customer Service and Organizational skills.
• High School Diploma; Bachelor's Degree preferred but not required.

Responsibilities

• Handle moderate to complex Workers' Compensation Lost Time claims in New Mexico.
• Manage a pending of 80 - 95 files which includes handling claims from inception to close.
• Investigating claims to determine validity and extent of liability.
• Properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses, and others; coordinate medical treatment for injured workers.
• Review and evaluate documentation, including applications, reports, and statements.
• Ensure legal, regulatory, and fair claims handling compliance.
• Identify claims with subrogation potential and pursue reimbursement.
• Set or recommend reserves based on results of claim investigation.

Skills

Attention to detail

Customer service

Organizational skills

Education

New Mexico Adjuster License

Bachelor's degree preferred

Job description

Our client is seeking to add a Senior Workers' Compensation Claims Examiner to their New Mexico operations. This role will consist of handling moderate to complex Workers’ Compensation Lost Time claims throughout the state of New Mexico from inception to close. Qualified candidates should possess an active NM adjuster’s license while also residing in the state.

• Handle moderate to complex Workers' Compensation Lost Time claims in New Mexico.
• Manage a pending of 80 - 95 files which includes handling claims from inception to close.
• Investigating claims to determine validity and extent of liability.
• Properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses, and others; coordinate medical treatment for injured workers.
• Review and evaluate documentation, including applications, reports, and statements.
• Ensure legal, regulatory, and fair claims handling compliance.
• Identify claims with subrogation potential and pursue reimbursement.
• Set or recommend reserves based on results of claim investigation.

Requirements

• 4 - 8+ years of Workers' Compensation Lost Time claims handling experience
• Must be well-versed in New Mexico Workers’ Compensation Law
• New Mexico Adjuster License is required
• Must reside in the state of New Mexico
• Excellent Customer Service and Organizational skills
• High School Diploma; Bachelor's Degree preferred but not required

Salary/Benefits

• $85,000 to $110,000 annual base salary, depending on experience
• Ability to work from home
• Competitive Medical, Dental, Vision and Life plans