Workers Compensation Claims Examiner III _ Temp

Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines.

Requirements

• Effectively manages a caseload of 150 to 180 workers' compensation files, including very complex claims.
• Initiates and conducts investigation in a timely manner.
• Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.
• Manages medical treatment and medical billing, authorizing as appropriate.
• Refers cases to outside defense counsel. Directs and manages as appropriate.
• Communicates with claimants, providers and vendors regarding claims issues.
• Computes and set reserves within Company guidelines.
• Settles and/or finalize all claims and obtains authority as designated.
• Maintains diary system for case review and documents file to reflect the status and work being performed on the file.
• Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.
• Adheres to all Company policies and procedures.
• Conducts file reviews independently.

Benefits

• Medical, Dental & Vision Insurance
• Life & Disability Insurance
• 401(K) Plan
• Paid time off
• Paid holidays