Workers Compensation Claims Examiner II Irving, TX

TEEMA Group; Irving (TX); On-site; USD 70,000 - 75,000; Full time

Job summary

TEEMA Group is seeking an experienced Workers’ Compensation Indemnity Claims Examiner II in Irving, TX. This on-site role handles a large caseload of indemnity claims, requiring solid knowledge of workers’ compensation statutes and strong judgment for settlements and reserves.

You will evaluate medical documentation, maintain compliance with deadlines, and escalate high-exposure issues as needed. Collaboration with supervisors and counsel is essential in complex matters.

Qualifications

• 3–5 years of related claims experience.
• Experience directly managing workers’ compensation indemnity claims, including moderate to complex and litigated files.
• Technical knowledge of applicable workers’ compensation statutes, regulations, and medical terminology.
• Strong analytical skills and the ability to make independent claims handling decisions within assigned authority.
• Ability to prioritize a substantial caseload and recognize matters requiring supervisory review.
• Excellent written and verbal communication skills.
• Ability to work professionally with individuals at all levels of the business.
• Any license or certification required by applicable state regulations.

Responsibilities

• Manage a caseload of approximately 150-180 workers’ compensation indemnity claims.
• Evaluate claim information, medical documentation, and applicable statutory requirements to guide claims handling decisions.
• Calculate, establish, and adjust reserves based on claim exposure.
• Authorize payments and settlements within assigned authority and company and client guidelines.
• Identify and escalated significant exposure, unusual compensability issues, sensitive client concerns, and decisions exceeding authority.
• Refer claims to defense counsel as appropriate and monitor litigation activities.
• Consult with your supervisor on significant legal developments and settlement strategy.
• Communicate claim status and technical information clearly to claimants, clients, counsel, and internal staff.
• Maintain accurate claim documentation and meet applicable deadlines and client handling requirements.

Skills

Indemnity claims handling

Analytical skills

Independent decision making

Communication skills

Caseload management

WC claims knowledge

Licenses/Certifications

Education

Bachelor's degree

Tools

Microsoft Word

Excel

Job description

Job Title: Workers’ Compensation Indemnity Claims Examiner II
Job ID:90956
Location: Irving, Texas –On-site / Hybrid if outside the DFW

Overview:
Our client is seeking an experienced Workers’ Compensation Indemnity Claims Examiner to manage claims of moderate to complex difficulty from inception through resolution. Under general supervision, you will exercise independent judgment, manage litigation, evaluate claim exposure, and authorize payments and settlements within assigned authority. This role requires sound technical knowledge and the judgment to seek supervisory guidance on unusual, high-exposure, or sensitive matters.

What you will be doing:

• Manage a caseload of approximately 150-180 workers’ compensation indemnity claims.
• Evaluate claim information, medical documentation, and applicable statutory requirements to guide claims handling decisions.
• Calculate, establish, and adjust reserves based on claim exposure.
• Authorize payments and settlements within assigned authority and company and client guidelines.
• Identify and escalated significant exposure, unusual compensability issues, sensitive client concerns, and decisions exceeding authority.
• Refer claims to defense counsel as appropriate and monitor litigation activities.
• Consult with your supervisor on significant legal developments and settlement strategy.
• Communicate claim status and technical information clearly to claimants, clients, counsel, and internal staff.
• Maintain accurate claim documentation and meet applicable deadlines and client handling requirements.

What you must have:

• Three to five years of related claims experience, or an equivalent combination of education and experience.
• Experience directly managing workers’ compensation indemnity claims, including moderate to complex and litigated files.
• Technical knowledge of applicable workers’ compensation statutes, regulations, and medical terminology.
• Strong analytical skills and the ability to make independent claims handling decisions within assigned authority.
• Ability to prioritize a substantial caseload and recognize matters requiring supervisory review.
• Excellent written and verbal communication skills.
• Ability to work professionally with individuals at all levels of the business.
• Any license or certification required by applicable state regulations.

Nice to have:

• Bachelor’s degree in a related field.
• Proficiency in Microsoft Word and Excel.

Salary/Rate Range:$70,000 to $75,000

Thank you for your interest in this opportunity. If you are selected to move forward in the process, we will contact you directly. If you do not hear from us, we encourage you to continue visiting our website for other roles that may be a good fit.

For more information about TEEMA and to consider other career opportunities, please visit our website at www.teemagroup.com