Workers Compensation Claims Examiner III

TeemaGroup; Town of Texas (WI); On-site; USD 39,000 - 58,000; Full time

Job summary

TeemaGroup in Irving, TX seeks an experienced indemnity claims examiner to manage all aspects of workers’ compensation claims from inception to conclusion under minimal supervision. This in-office role is a 3–4 month contract with potential extension.

You will interact with clients and claimants by phone, prepare captioned reports, ensure timely benefit payments, and comply with state laws. Five or more years of WC claims experience and a TX Adjuster license are required.

Qualifications

• Education/Experience: High School Diploma or GED required; Bachelor’s degree in related field preferred.
• Five (5) or more years related Workers’ Compensation claims experience.
• Workers’ Compensation Adjusters 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 on claims meeting client requirements.
• Communicate in a professional manner and provide excellent customer service.
• Assist employers and employees understand the Workers’ Compensation process.
• Investigate, evaluate, determine compensability, pay benefits timely and comply with all statutory requirements.

Skills

Professional communication

Customer service

Organized

CAN-DO attitude

Team interaction

Education

High School Diploma or GED

Bachelor’s degree in related field

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