What are the responsibilities and job description for the Workers Compensation Claims Examiner position at Mary Kraft HR?
Job Profile
Job Title
Workers Compensation Claims Examiner
Location
Remote
Hire Type
Contingent
Hourly
$50
Work Model
Monday – Friday
Contact Phone
(443)-345-3305
Contact Email
sean@marykraft.com
Nature & Scope:
Positional Overview
Mary Kraft is seeking an experienced Workers Compensation Claims Examiner to analyze and process complex workers’ compensation claims, ensuring accurate determination of benefits due and timely resolution. The role focuses on high-exposure claims that may involve litigation and rehabilitation, with a strong emphasis on maintaining industry best practices, effective communication with claimants and clients, and identifying subrogation opportunities for cost recovery.
Role & Responsibility:
Tasks That Will Lead To Your Success
- Analyzing and processing complex workers’ compensation claims by gathering information and determining claim exposure. You will develop detailed action plans to guide each claim toward a timely resolution.
- Negotiating settlements within your designated authority and managing claim payments, including the calculation and assignment of reserves throughout the claim lifecycle.
- Preparing all necessary state filings within statutory limits and managing the litigation process to ensure timely, cost-effective resolutions.
- Coordinating vendor referrals, such as independent adjusters, to assist with thorough investigations and supporting claims.
- Identifying and pursuing subrogation opportunities, including Second Injury Fund recoveries and Social Security/Medicare offsets.
- Reporting large claims to excess carriers and ensuring accurate claims coding and documentation.
- Maintaining professional relationships with both claimants and clients through effective communication.
- Referring cases to supervisors as needed and providing support for the organization’s quality programs.
- Traveling as required to meet the demands of the role.
Skills & Experience:
Qualifications That Will Help You Thrive
- Bachelor’s degree from an accredited college or university is preferred.
- Professional certification relevant to the line of business is a plus.
- A minimum of five (5) years of claims management experience or an equivalent combination of education and experience is required.
- At least three (3) years of workers’ compensation claims handling experience in multiple Southeastern states is necessary.
- In-depth understanding of workers’ compensation regulations, including recoveries, offsets, deductions, claim and disability duration, and cost containment principles.
- Knowledge of medical management practices and procedures for applying Social Security and Medicare guidelines as they pertain to workers’ compensation.
- Excellent oral and written communication skills, including strong presentation abilities.
- Proficiency in Microsoft Office and other relevant software tools.
- Exceptional analytical, interpretive, and organizational skills, with the ability to handle work-related stress and manage multiple priorities.
- Strong interpersonal and negotiation skills, with a demonstrated ability to work effectively within a team environment.
- Ability to consistently meet or exceed service expectations.
Salary : $34 - $46
