Workers Compensation Claims Examiner

SDI Staffing; Irving (TX); Hybrid; USD 70,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Job summary

SDI Staffing seeks an experienced Workers' Comp Claims Examiner in Irving, TX. This full-time role offers in-office and hybrid options; 100% remote possible if you reside outside Irving. Base salaries range from $70k to $85k depending on level and experience, with a comprehensive benefits package.

You will manage a caseload of 110–150 claims, communicate with claimants, employers, medical providers, and vendors, and assess reserves, compensability, and litigation issues to determine resolutions.

Qualifications

• Texas Adjuster License is required.
• Experience working with workers' comp claims.
• Strong organizational skills and ability to maintain a diary system.
• Excellent written and verbal communication; ability to explain claims information clearly.

Responsibilities

• Managed a caseload of approximately 110 to 150 workers' comp claims depending on experience.
• Communicates with claimants, employers, medical providers, and vendors regarding claim status, treatment, billing, and other issues.
• Calculates and adjusts reserves within authority and guidelines.
• Evaluates compensability, medical, disability, and litigation issues and develops resolution strategies.
• Maintains a diary system for timely case review and documents claim files.
• Communicates relevant information to clients, including injury trends and safety concerns.
• Participates in file reviews as needed.
• Performs other duties as assigned.

Skills

Analytical skills

Organizational skills

Written and verbal communication

Microsoft Word

Excel

Education

Texas Adjuster License

Tools

Microsoft Word

Excel

Job description

HOURS

Full-Time

DURATION

Direct Hire

WORKPLACE

In office and hybrid is preferred. 100% remote work will be considered if Workers Compensation Examiner resides outside of Irving, Texas.

PAY

• Workers Comp Claims Examiner II: $70,000 - $75,000 base salary (3 + years experience)
• Workers Comp Claims Examiner III: $80,000 to $85,000 base salary (4 years +)

BENEFITS

• Full comprehensive benefits package including medical, dental, vision, and PTO.

Responsibilities

• Managed a caseload of approximately 110 to 150 workers comp claims depending on experience.
• Communicates professionally with claimants, employers, medical providers, and vendors regarding claim status, treatment, billing, and other claims issues.
• Calculates, establishes, and adjusts reserves within assigned authority and company guidelines.
• Evaluates difficult compensability, medical, disability, and litigation issues and develops appropriate claims resolution strategies.
• Maintains a diary system for timely case review and documents claim files to accurately reflect claim status and handling activities.
• Promptly communicates relevant information to clients, including injury trends and safety concerns.
• Participate in file reviews as needed.
• Performs other duties as assigned.

Qualifications

• Must have experience working with cites, counties, and public municipalities is a plus!
• Texas Adjuster License is required.
• Ability to investigate and manage medical-only claims within assigned authority and established guidelines.
• Analytical skills to evaluate claim information, medical documentation, and billing.
• Ability to recognize changes in claim exposure or complexity and seek supervisory guidance promptly.
• Strong organizational skills and the ability to maintain a diary system, prioritize tasks, and meet deadlines.
• Effective written and verbal communication skills, including the ability to explain claims information clearly to claimants, clients, and staff.
• Ability to interact professionally with individuals at all levels of the business environment.
• Proficiency in Microsoft Word and Excel preferred.