Workers Compensation Claims Examiner III

TEEMA; Irving (TX); On-site; USD 60,000 - 90,000; Full time

Job summary

TeemaGroup in Irving, TX is seeking a Claims Examiner to manage indemnity claims from inception to resolution under established guidelines. The role requires frequent interaction with clients, claimants, and TRISTAR staff in the office, with a strong emphasis on accuracy and timeliness.

You will handle loss time Workers’ Compensation claims in Texas, follow best practices, prepare captioned reports, and communicate professionally to assist employers and employees through the workers’

Qualifications

• High School Diploma or GED required; Bachelor’s degree in related field preferred; five or more years related experience; or equivalent combination.
• Workers’ Compensation Adjuster License for the State of Texas.

Responsibilities

• Handle loss time Workers’ Compensation claims in TX Office—Texas Jurisdiction
• Handle claims as per Best Practices, SOC 1 and client Claims Handling Instructions
• Prepare a formal captioned report meeting client requirements
• Maintain a CAN-DO attitude with professional communication
• Provide great customer service and assist employees through the process
• Investigate, evaluate, determine compensability, and pay benefits timely

Skills

Claims handling experience

Client communication

Customer service

Organizational skills

Microsoft Office / basic software

Education

Bachelor's degree in related field

Texas Workers’ Compensation Adjuster License

Tools

Claims management software

Job description

TeemaGroup

Full-time- CONTRACT 3-4 months could be longer

In-Office | Irving, TX, United States

POSITION SUMMARY

Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; therefore consistently being at work in the office, in a timely manner, is inherently required of this position.

DUTIES AND RESPONSIBILITIES

• Handle loss time Workers’ Compensation claims in TX Office—Texas Jurisdiction
• Handle claims as per Best Practices, SOC 1 and client Claims Handling Instructions
• The ability to prepare a formal captioned report on claims meeting client requirements
• Well organized and CAN-DO attitude.
• Ability to effectively communicate in a professional manner
• Provide great customer service
• Assist employers and their employees understand the Workers’ Compensation process
• Investigate, evaluate, determine compensability, pay benefits timely as required and comply with all statutory requirements
• A good sense of urgency
• Ability to get along well with others with a positive attitude

EQUIPMENT OPERATED/USED

Computer, 10-key, fax machine, copier, printer, and other office equipment.

SPECIAL EQUIPMENT OR CLOTHING

Follow company dress code

QUALIFICATIONS REQUIRED

Education/Experience: High School Diploma or GED required; Bachelor’s degree in related field (preferred); five (5) or more years related experience; or equivalent combination of education and experience.

Other Qualifications: Workers’ Compensation Adjusters License for the State of Texas

Education & Experience

• Bachelor’s degree in a related field (preferred)
• Minimum 5+ years of progressive workers’ compensation claims experience
• Demonstrated experience handling complex and litigated indemnity claims