Claims Examiner III (Hybrid)
Tristar InsuranceSacramento, California, United States
Posted March 26, 2026
80000 - 99000
Full Time
About the Company
Tristar Insurance is a veteran‑owned brokerage that partners with leading carriers to deliver customized insurance solutions for small businesses, start‑ups, and individuals. The firm specializes in a broad portfolio—including general liability, workers’ compensation, cyber and technology insurance, as well as personal coverage such as homeowners, auto, and motorcycle policies—ensuring clients protect the assets that matter most. Tristar’s competitive pricing strategy and hands‑on client service help businesses and families maintain continuity in the face of unforeseen claims. With a culture rooted in integrity, dedication, and a deep respect for the hard work of its clients, Tristar is a trusted partner for those seeking reliable, cost‑effective coverage.
Job Description
Claims Examiner III (Hybrid): This permanent position covers open desks due to vacations, leaves of absence, new business onboarding, and increased pending inventories. The role requires managing complex Workers’ Compensation claims from inception to conclusion, interacting with clients, claimants, and staff, and adhering to company policies and procedures.
Requirements
- Effectively manage a Temporary caseload of Workers’ Compensation claim files
- Initiate and conduct investigations in a timely manner
- Determine compensability of claims and administer benefits
- Manage medical treatment and medical billing
- Refers cases to outside defense counsel and participates in litigated matters
- Communicate with claimants, attorneys, providers, and vendors regarding claims issues
- Maintain a diary system for case review and document file status
- Identify and review claims for Apportionment assignment
- Identify and investigate subrogation potential and pursue recovery
Benefits
- Medical, Dental, Vision Insurance
- Life and Disability Insurance
- 401(k) Plan
- Paid Holidays
- Paid Time Off
- Referral bonus