What are the responsibilities and job description for the Claims Examiner III position at TEEMA Group?
Claims Examiner III – Workers’ Compensation
Role Summary
The Claims Examiner III is responsible for independently managing the full lifecycle of Workers’ Compensation indemnity claims, from initial reporting through final resolution. Operating with minimal supervision, this role requires strong analytical judgment, regulatory knowledge, and a commitment to delivering timely, accurate, and compliant claim outcomes.
This position plays a critical role in supporting employers and injured employees by ensuring claims are handled with professionalism, urgency, and integrity. The ideal candidate is organized, service-oriented, and confident in navigating complex claim scenarios within established authority levels and statutory guidelines.
This is an excellent opportunity for an experienced claims professional seeking autonomy, responsibility, and meaningful impact in a structured and collaborative office environment.
Duties & Responsibilities
Manage loss-time Workers’ Compensation claims within Texas jurisdiction from inception through closure
Investigate, evaluate, and determine compensability in accordance with statutory regulations and internal guidelines
Administer and issue benefit payments accurately and within required timelines
Ensure compliance with all applicable state laws, regulatory standards, and client-specific handling instructions
Prepare detailed, formal captioned reports that meet client documentation requirements
Communicate effectively and professionally with clients, claimants, employers, attorneys, and internal stakeholders
Provide exceptional customer service while assisting employers and injured employees in understanding the Workers’ Compensation process
Maintain organized, accurate claim files and documentation
Demonstrate strong time management and sense of urgency in claim handling
Collaborate with management and fellow claims professionals to ensure consistent, high-quality outcomes
Consistently maintain on-site office attendance in a timely manner to support team operations and client engagement
other duties as assigned
Required Qualifications
High School Diploma or GED required
Minimum five (5) years of related Workers’ Compensation claims handling experience, or equivalent combination of education and experience
Current Texas Workers’ Compensation Adjuster License
Strong knowledge of Texas Workers’ Compensation statutes and indemnity claim handling
Ability to manage claims independently with minimal supervision
Excellent written and verbal communication skills
Strong organizational skills and attention to detail
Professional demeanor with a positive, team-oriented attitude
Ability to interact effectively with clients, claimants, and internal teams
Desired Qualifications
Bachelor’s degree in Business, Risk Management, Insurance, or related field (preferred)
Experience handling complex or high-exposure indemnity claims
Demonstrated ability to prepare formal client-ready reports
Proven track record of delivering high-quality customer service
Strong problem-solving and decision-making skills
About the Organization
This organization is a professional risk management and claims administration firm committed to delivering responsive, compliant, and high-quality claims services. The culture emphasizes accountability, collaboration, and client satisfaction while empowering employees with the autonomy and support needed to succeed.
Location & Work Type
On-site position in an office environment.
Full-time, exempt role. Regular in-office attendance is required due to the collaborative and client-facing nature of the position.
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