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Job Title: Claims Examiner - Workers Compensation
Location: Memphis, TN (REMOTE)
Work Hours: TBA
Benefits: Medical Insurance, Dental Insurance, Vision Insurance, 401K
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Prepares necessary state fillings within statutory limits.
Manages the litigation process; ensures timely and cost effective claims resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
Ensures claim files are properly documented and claims coding is correct.
Refers cases as appropriate to supervisor and management.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
QUALIFICATION
Education & Licensing
Experience
Skills & Knowledge
Other
$56k-72k (estimate)
03/25/2024
05/09/2024
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The following is the career advancement route for 100% REMOTE Workers Compensation Claims Examiner (ND2023) positions, which can be used as a reference in future career path planning. As a 100% REMOTE Workers Compensation Claims Examiner (ND2023), it can be promoted into senior positions as a Claims Examiner IV that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary 100% REMOTE Workers Compensation Claims Examiner (ND2023). You can explore the career advancement for a 100% REMOTE Workers Compensation Claims Examiner (ND2023) below and select your interested title to get hiring information.