What are the responsibilities and job description for the Claims Examiner / Customer Service position at BCForward?
Job Title: Claims Examiner (Workers’ Compensation)
Location: New Haven, CT (Onsite – 5 days/week)
Address: New Haven, Connecticut 06511
⏰ Schedule: 8:30 AM – 5:00 PM (EST)
Pay Rate: $35/hr
Employment Type: Contract
Job Overview
We are seeking a Claims Examiner to manage workers’ compensation claims from initial setup through resolution. The ideal candidate will be responsible for conducting investigations, evaluating claims, coordinating with stakeholders, and ensuring compliance with applicable regulations while maintaining excellent customer service.
Key Responsibilities
- Manage workers’ compensation claims from setup to closure.
- Review claim and policy details to support claim investigations.
- Conduct three-point investigations involving claimants, insured parties, and medical providers.
- Gather statements and documentation to determine claim compensability.
- Communicate claim decisions including approvals or denials to claimants, insured parties, and attorneys.
- Prepare reports related to investigations, settlements, claim evaluations, and denials.
- Administer statutory medical and indemnity benefits throughout the claim lifecycle.
- Set and monitor reserves for medical, indemnity, and claim expenses.
- Work with attorneys to manage hearings and litigation.
- Coordinate with vendors, nurse case managers, telephonic case managers, and rehabilitation managers.
- File required workers’ compensation forms and electronic data with state agencies.
- Identify and refer claims for subrogation opportunities.
- Collaborate with internal teams including technical assistants, investigators, nurse consultants, and supervisors.
Required Skills & Competencies
- Experience in claims handling, insurance, or related fields.
- Strong customer service and communication skills.
- Ability to handle high-volume workloads in a fast-paced environment.
- Excellent time management, organization, and multitasking abilities.
- Analytical skills to evaluate claim details and determine appropriate resolution.
- Ability to work collaboratively with internal teams and external stakeholders.
- Strong written and verbal communication skills.
- Proficiency in Microsoft Office (Excel, Word, Outlook).
Preferred Background
Candidates with experience in any of the following areas are encouraged to apply:
- Workers’ Compensation Claims
- Short-Term / Long-Term Disability Claims
- Auto Personal Injury Protection (PIP)
- Medical Billing or Medical Claims
- General Liability Claims
- Insurance or Legal industry experience
- Medical terminology knowledge
Professional designations such as AIC, RMA, or CPCU coursework are a plus.
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class places to work.
BCforward is an equal opportunity employer.
Salary : $30 - $35