Remote Workers Compensation Claims Examiner

As a dedicated and detail-oriented Workers Compensation Claims Examiner, you will be responsible for managing claims from inception to closure, ensuring timely and accurate handling of cases with low to moderate medical and indemnity benefit exposure. Your expertise in California workers compensation laws and regulations will guide you in resolving complex claims efficiently.

Key Responsibilities:

• Receives and reviews new work comp claims involving low to moderate medical, indemnity and occasional legal exposure.
• Completes initial contacts to obtain necessary information, verify coverage, determine compensability, and develop a plan of action.
• Accurately evaluates and pays benefits in compliance with statutory and company guidelines.
• Proactively coordinates or monitors medical treatment to continue to move the claim forward.
• Regularly reviews caseload and proactively takes action to guide claims efficiently and effectively to closure.

Requirements:

• One to two years of related claims, medical, legal or insurance industry experience preferred.
• Excellent communication and customer service skills and knowledge of an imaged environment.
• Self-motivated with excellent analytical, problem-solving, and decision-making skills.
• Strong ability to multi-task and prioritize.
• Knowledge of workers' compensation laws, regulations, and statutes preferred.