What are the responsibilities and job description for the Workers Compensation Claims Examiner position at Mary Kraft HR?
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 an experienced Claims Examiner to analyze complex workers’ compensation claims in compliance with California regulations. This role involves handling high-exposure claims, litigation management, and rehabilitation efforts while ensuring timely adjudication and resolution.
Role & Responsibilit y :
Tasks That Will Lead To Your Success
- Investigate and analyze complex workers’ compensation claims, determining benefits due and creating detailed action plans for timely resolutions.
- Negotiate claim settlements within designated authority levels.
- Assign and monitor appropriate reserves for claims throughout their lifecycle.
- Calculate and issue timely claim payments, including adjustments, and settle claims as appropriate.
- Prepare and submit state filings within statutory limits.
- Manage litigation processes to ensure cost-effective and timely claims resolution.
- Refer cases to vendors for additional investigation or litigation management.
- Apply strategic techniques to reduce overall claims costs, including vendor partnerships.
- Manage claim recoveries, such as subrogation and second injury fund recoveries, and coordinate Social Security and Medicare offsets.
- Communicate claim activities with claimants and clients while maintaining professional client relationships.
- Maintain accurate and detailed claim files and ensure correct coding.
- Escalate cases to supervisors as appropriate.
Skills & Experience :
Qualifications That Will Help You Thrive
Salary : $50
