Workers Compensation Claims Examiner

SDI Staffing; Houston (TX); Hybrid; USD 75,000 - 88,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Life insurance

Career growth opportunities

Job summary

SDI Staffing is seeking an experienced Workers' Compensation Claims Examiner to manage a caseload of Texas subscriber claims. This role offers the flexibility of remote or hybrid work arrangements, but candidates must reside in Texas. The ideal candidate has at least 5 years of claims handling experience and holds a Texas Workers' Compensation Adjuster's License.

The position comes with a competitive salary ranging from $75,000–$88,000 annually, along with a comprehensive benefits package that includes medical and dental insurance, strong career growth opportunities, and a positive team environment.

Qualifications

• Minimum 5+ years of Texas subscriber workers' compensation claims handling experience.
• Strong knowledge of Texas workers' compensation laws and regulations.
• Ability to effectively manage a high-volume caseload.

Responsibilities

• Manage a caseload of 110–150 workers' compensation claims from inception through resolution.
• Investigate, evaluate, and determine compensability of claims.
• Coordinate with injured workers, employers, medical providers, and other stakeholders.

Skills

Texas workers' compensation claims handling

Analytical skills

Excellent communication

Organizational skills

Education

Texas Workers' Compensation Adjuster's License

Job description

Location: Texas (Remote or Hybrid) Must reside in Texas to be considered for remote role
Job Type: Direct Hire
Schedule: Full-Time, Monday–Friday, 8:00 AM–5:00 PM
Compensation: $75,000–$88,000 annually, depending on experience (higher compensation may be considered for highly qualified candidates with 10+ years of experience)

Our client, a well-established organization in the insurance industry, is seeking an experienced Workers' Compensation Claims Examiner to join their team. Candidates must reside in Texas. This position offers flexibility with either a fully remote or hybrid work arrangement, depending on the candidate’s location and qualifications.

Position Summary

The Workers' Compensation Claims Examiner III is responsible for independently managing a caseload of approximately 110–150 Texas subscriber workers' compensation claims, including highly complex files. The ideal candidate will have strong technical claim handling expertise, excellent communication skills, and a thorough understanding of Texas workers' compensation regulations.

Key Responsibilities

• Manage a caseload of 110–150 workers' compensation claims from inception through resolution.

• Investigate, evaluate, and determine compensability of claims.

• Analyze medical, legal, and vocational information to make sound claim decisions.

• Coordinate with injured workers, employers, medical providers, attorneys, and other stakeholders.

• Establish appropriate reserves and authorize benefits in accordance with Texas workers' compensation laws.

• Maintain accurate and timely claim documentation.

• Ensure compliance with all regulatory requirements and company standards.

Qualifications

• Minimum 5+ years of Texas subscriber workers' compensation claims handling experience.

• Active Texas Workers' Compensation Adjuster's License required.

• Experience handling complex and litigated claims.

• Strong knowledge of Texas workers' compensation laws and regulations.

• Excellent analytical, organizational, and communication skills.

• Ability to effectively manage a high-volume caseload while maintaining quality standards.

Benefits

Our client offers a comprehensive benefits package, including:

• Medical, dental, and life insurance

• Competitive compensation

• Remote or hybrid work flexibility

• Positive team environment

• Strong corporate culture and career growth opportunities

If you are an experienced Texas Workers' Compensation Claims professional seeking a stable organization with an excellent work environment and flexible work options, we encourage you to apply.