What are the responsibilities and job description for the Workers Compensation Claims Examiner position at Imagine Staffing Technology?
Job Description
Job Description
Job Profile
Job Title
Workers Compensation Claims Examiner
Location
Remote
Hire Type
Contingent
Hourly
Work Model
Monday – Friday
Contact Phone
443 ) -345-3305
Contact Email
sean@marykraft.com
Nature & Scope : Positional Overview
Mary Kraft is seeking a skilled Workers Compensation Claims Examiner with 3 years of California workers' compensation (WC) experience to handle complex and high-exposure claims. This role requires expertise in analyzing and resolving technically challenging claims involving litigation and rehabilitation, ensuring compliance with service expectations, and negotiating settlements. Knowledge of public entity claims, particularly County of Los Angeles experience, is highly desirable.
Role & Responsibilit y :
Tasks That Will Lead To Your Success
- Investigate and process complex workers’ compensation claims to determine exposure and benefits due.
- Develop and execute well-structured action plans to resolve claims efficiently and effectively.
- Negotiate and approve settlements within designated authority limits.
- Calculate and assign reserves to claims, ensuring reserve adequacy throughout the claim lifecycle.
- Process and approve timely benefit payments and adjustments.
- Manage the litigation process to ensure timely and cost-effective claim resolutions.
- Coordinate vendor referrals for additional investigations or litigation management.
- Prepare and submit state filings within statutory limits.
- Maintain accurate claim documentation and ensure proper coding.
- Use strategic vendor partnerships and cost-containment techniques to minimize overall claim costs.
- Manage recoveries, including subrogation, Second Injury Fund recoveries, and Social Security / Medicare offsets.
- Communicate claim activity and resolutions with claimants and clients.
- Maintain professional and collaborative client relationships.
- Refer cases to supervisors or management as needed in accordance with client service instructions.
- Support the organization’s quality programs and perform other duties as assigned.
- Travel as required.
Skills & Experience :
Qualifications That Will Help You Thrive
Salary : $50
