Workers' Compensation Claims Investigator

Evolving Solution Services; Northern (KY); Hybrid; USD 60,000 - 90,000; Full time

Job summary

Evolving Solution Services is seeking a Workers' Compensation Claims Examiner in Washington, DC. You will receive, investigate, and administer workers' compensation claims from inception through closure, evaluating compensability and coordinating with injured workers and providers to support timely decisions.

The role requires strong analytical, communication, and documentation skills, with experience in claims management systems and knowledge of workers' compensation laws.

Qualifications

• Bachelor's degree or higher required or equivalent experience.
• Strong analytical and investigative abilities for assessing claims.
• Excellent written and verbal communication with attention to detail.

Responsibilities

• Receive, review, and process first reports of injury, notices of loss, and workers' compensation claims.
• Investigate and evaluate claims to determine compensability and entitlement to medical benefits.
• Administer and manage medical-only workers' compensation claims from inception through closure.
• Collect, analyze, and evaluate claim-related information including medical and employment records, witness statements, and treatment plans.
• Draft notices, correspondence, and claim determinations; maintain timely claim files.

Skills

Analytical skills

Investigative skills

Communication skills

MS Office

Education

Bachelor's degree

Tools

Claims management systems

Medical terminology knowledge

Job description

Evolving Solution Services is seeking a Workers' Compensation Claims Examiner in Washington, DC. You will receive, investigate, and administer workers' compensation claims from inception through closure, evaluating compensability and coordinating with injured workers and providers to support timely decisions.

The role requires strong analytical, communication, and documentation skills, with experience in claims management systems and knowledge of workers' compensation laws.