Workers' Compensation Claims Examiner

NRI, Inc.; Washington (District of Columbia); On-site; USD 41,328,000 - 68,880,000; Full time

Job summary

NRI Staffing is seeking an experienced Workers' Compensation Claims Examiner to support a government contracting opportunity in the Washington, DC/DMV Area. The ideal candidate will handle claims from initial investigation through resolution, reviewing medical documentation and determining compensability.

Key responsibilities include reviewing and adjudicating claims, establishing reserves, managing cases through full lifecycle, participating in hearings or settlements, applying relevant laws

Qualifications

• Experience handling workers' compensation claims from investigation to resolution.
• Ability to review medical documentation and determine compensability.
• Experience establishing claim reserves and managing cases through hearings or settlements.

Responsibilities

• Review, investigate, and adjudicate workers' compensation claims.
• Analyze medical records, treatment plans, and supporting documentation to make claim determinations.
• Establish and maintain appropriate claim reserves.
• Manage claims throughout the full lifecycle and ensure timely case resolution.
• Apply applicable workers' compensation laws, regulations, policies, and procedures.
• Participate in hearings, mediations, settlement conferences, and other claim-related proceedings as needed.
• Maintain accurate and confidential claim documentation.
• Communicate with claimants, medical providers, attorneys, employers, and other stakeholders.

Skills

Claims investigation

Medical records review

Reserves management

Case management

Hearings & settlements

Job description

Workers' Compensation Claims Examiner

Location: Washington, DC / DMV Area

Employment Type: Contract

Industry: Government / Public Sector

NRI Staffing is seeking an experienced Workers' Compensation Claims Examiner to support an upcoming government contracting opportunity.

The ideal candidate will have strong experience handling workers' compensation claims from initial investigation through resolution, including reviewing medical documentation, determining compensability, establishing reserves, managing ongoing cases, and participating in hearings or settlement discussions.

Key Responsibilities

• Review, investigate, and adjudicate workers' compensation claims.
• Analyze medical records, treatment plans, and supporting documentation to make claim determinations.
• Establish and maintain appropriate claim reserves.
• Manage claims throughout the full lifecycle and ensure timely case resolution.
• Apply applicable workers' compensation laws, regulations, policies, and procedures.
• Participate in hearings, mediations, settlement conferences, and other claim-related proceedings as needed.
• Maintain accurate and confidential claim documentation.
• Communicate with claimants, medical providers, attorneys, employers, and other stakeholders.