Workers Compensation Claims Examiner- Remote (TX)

TEEMA; Houston (TX); Remote; USD 79,200 - 96,800; Full time

Job summary

TEEMA is seeking a Workers Compensation Claims Examiner in Houston, TX. The successful candidate will manage a complex indemnity caseload, conducting thorough investigations and ensuring compliance with Texas WC statutes.

This role demands strong analytical skills and a Texas Workers’ Compensation Adjuster License. With a salary of up to $88,000 per year, this opportunity is ideal for experienced adjusters looking for career growth.

Qualifications

• Minimum of five (5) years of workers’ compensation claims experience required.
• Indemnity experience is essential.
• Ability to independently manage very complex claims.

Responsibilities

• Effectively manage a caseload of 110–150 files.
• Conduct thorough claim investigations.
• Determine compensability and administer benefits.

Skills

Texas Workers’ Compensation Adjuster License

Analytical and investigative skills

Excellent written and verbal communication

Technical knowledge of Texas WC regulations

Proficiency in Microsoft Word and Excel

Education

High School Diploma or GED

Bachelor’s degree in a related field

Job description

Job Title: Workers Compensation Claims Examiner- Houston, TX

Job ID: 88105
Location: Houston, Texas–Hybrid/Remote

Overview

Our client is one of the most respected third‑party administrators (TPAs) in the U.S. insurance industry. With over 30 years of experience, they deliver claims management, loss control, and risk management services across workers’ compensation, general liability, property, and disability lines. Operating coast to coast with offices in major markets, our client partners with self‑insured employers, captives, and carriers who demand sophisticated, outcome‑driven claims handling. The Houston branch is a cornerstone of their workers’ compensation operations — serving complex, high‑volume clients across Texas and beyond. Our client is known for a culture of technical excellence, compliance rigor, and genuine investment in their examiners’ professional growth. This is a company where your expertise is recognized, your caseload is meaningful, and your work directly shapes client outcomes. Our client is actively expanding their Houston WC team to meet growing client demand. This is a senior‑level, individual‑contributor role where you will independently manage a complex indemnity caseload from first notice of loss through closure — with the authority and trust of an experienced examiner. If you hold a Texas WC adjuster license and have 5+ years handling indemnity files, our client wants to speak with you now. Under minimal supervision, the Claims Adjuster manages all aspects of indemnity workers’ compensation claims handling from inception through conclusion, within established authority levels and company guidelines. This is a senior individual‑contributor role requiring deep knowledge of Texas WC statute, strong investigative instincts, and the ability to independently manage a caseload of 110–150 files — including highly complex claims.

What you will be doing

• Effectively manage a caseload of 110–150 workers’ compensation files, including very complex and high‑exposure indemnity claims
• Initiate and conduct thorough claim investigations in a timely manner
• Determine compensability and administer benefits consistent with Texas state law and company guidelines
• Manage medical treatment and medical billing; authorize services as appropriate
• Communicate proactively with claimants, medical providers, and vendors regarding claim status and issues
• Compute and set reserves within established company authority levels
• Maintain a disciplined diary system for case review; document files to accurately reflect status and activity
• Communicate timely, accurate claim information to clients — including injury trends and safety‑related concerns
• Adhere to all company policies, procedures, and compliance requirements
• Conduct independent file reviews
• Perform other duties as assigned

What you must have

• High School Diploma or GED required. Bachelor’s degree in a related field preferred. A minimum of five (5) years of workers’ compensation claims experience required, or an equivalent combination of education and experience. Indemnity experience is essential.
• Texas Workers’ Compensation Adjuster License — this is a hard requirement. Candidates without this license will not be considered.
• Strong technical knowledge of Texas WC statutory regulations and medical terminology
• Analytical and investigative skills applied to complex, multi‑issue claims
• Excellent written and verbal communication skills — ability to convey technical information to claimants, clients, and colleagues
• Ability to interact professionally at all levels of the business environment
• Demonstrated ability to independently manage very complex claims to resolution
• Proficiency in Microsoft Word and Excel (preferred)

Salary

Up to $88,000 per year

If you are looking for an amazing opportunity to get into a major insurance company as an experienced adjuster with career growth opportunities, submit your resume now!

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