Workers Compensation Claims Examiner I

3 weeks ago


Long Beach, United States Procom Full time
(Workers Compensation Claims Examiner I - Medical Claims) Intro

Our client, the largest privately held third party claims administrator in the United States, is seeking a Workers Compensation Medical Claims Examiner I. We are looking for a professional with 2-5 years of experience in Texas Workers' Compensation Claims and a Texas Workers' Compensation Adjuster's license.

(Claims Examiner I - Medical Claims) Job Details

As a Claims Examiner I, you will manage all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. This role involves considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other staff in the office. Duties include claims investigation, determination of claim compensability, management of medical treatment and billing, communication with claimants, providers and vendors, and participation in file reviews.

(Claims Examiner I - Medical Claims) Mandatory Skills

Candidates must have a technical knowledge of statutory regulations and medical terminology, excellent analytical skills, and superior written and verbal communication skills. Ability to interact with persons at all levels in the business environment and to independently and effectively manage very complex claims is required. Proficiency in Word and Excel is preferred.

(Claims Examiner I - Medical Claims) Desired Skills

A Texas Workers' Compensation Adjuster's license is required. A Bachelor's degree in a related field is preferred. Experience working with City of Houston claims is a major plus.

(Claims Examiner I - Medical Claims) Start Date

The start date for this position is as soon as possible.

(Claims Examiner I - Medical Claims) Location

The position can be filled in the office in Houston, TX or remotely from any location within the state of Texas. Occasional travel may be required if a remote worker's attendance is needed in the office.
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