Workers Compensation Claims Examiner

SDI Staffing; Lakewood (CO); Hybrid; USD 80,000 - 90,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

PTO

Job summary

SDI Staffing is seeking an experienced Workers' Compensation Claims Examiner for a hybrid role based in Lakewood, CO. The position is full-time and direct-hire, with a compensation range of $80,000 to $90,000 depending on experience.

The role involves managing a large caseload, conducting investigations, determining claim compensability, and coordinating medical treatment and billing. Strong communication skills and proficiency in Word/Excel are required, with a preference for state-licensed

Qualifications

• Bachelor's degree in a related field preferred.
• Colorado's adjuster license is preferred.
• Minimum of 2+ years of workers' compensation claims handling experience.
• Excellent written and verbal communication skills.

Responsibilities

• Manages an active caseload of 150 workers' compensation files, including medical only, indemnity, lifetime medical and permanent partial benefit claims.
• Initiates and conducts claims investigation in a timely manner.
• Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.
• Manages medical treatment and medical billing, authorizing as appropriate.
• Communicates with claimants, providers and vendors regarding claims issues.
• Computes and sets reserves within Company guidelines.
• Maintains diary system for case review and document file to reflect the status and work being performed on the file.
• Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.
• Participates in file reviews with clients, as needed.
• Other duties as assigned including claims management of other jurisdictional workers' comp claims.

Skills

Communication

Time management

Analytical thinking

Education

Bachelor's degree in related field

Colorado adjuster license preferred

Tools

Word

Excel

Job description

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 Lakewood, CO! HOURS: Full-Time DURATION: Direct Hire WORKPLACE: Hybrid: 3 days remote and 2 days in office PAY: $80,000 to $90,000 (depending on experience).

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

Responsibilities

• Effectively manages an active caseload of 150 workers compensation files, including medical only, indemnity, lifetime medical and permanent partial benefit claims.
• Initiates and conducts claims investigation in a timely manner.
• Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.
• Manages medical treatment and medical billing, authorizing as appropriate.
• Communicates with claimants, providers and vendors regarding claims issues.
• Computes and set reserves within Company guidelines.
• Maintains diary system for case review and document file to reflect the status and work being performed on the file.
• Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.
• Participates in file reviews with clients, as needed.
• Other duties as assigned and including claims management of other jurisdictional workers' comp claims.

Qualifications

• Bachelor's degree in a related field preferred.
• Colorado's adjuster license is preferred.
• Minimum of 2+ years of workers' compensation claims handling experience or an equivalent combination of education and experience.
• Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff.
• Proficient in Word and Excel (preferred).
• Knowledge of self-insured claims handling (preferred).