We're looking for a Claims Examiner - Workers Compensation to analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

Primary Purpose of the Role Analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

Essential Responsibilities May Include

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Qualifications

• Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
• Experience: 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing / Jurisdiction Knowledge: OR

Taking Care of You

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

The salary range for this role is $64,000 - $85,000 per year.

Job Data by YubHub.

The primary purpose of this role is to coordinate activities of absence programs for a specific client, assist/support the Benefits Program Manager, implement customer surveys, assist in client training and benefits fairs, and prepare reports for program administration.

Key responsibilities include:

• Serving as a liaison between the company and client human resources (HR) and employees in managing absence programs
• Communicating with clients, employees, healthcare providers, and company operations teams to resolve escalated issues
• Assisting in evaluating the results of absence programs and best practices in absence administration
• Maintaining records and files related to absence programs
• Monitoring satisfaction with leave and disability administration through periodic customer surveys
• Working with stakeholders to ensure continuous performance and process improvement
• Maintaining knowledge of legal requirements and best practices relevant to absence programs and administration
• Assisting with client training and development of communications
• Assisting in the administration of benefits fairs as needed

Requirements include:

• Bachelor's degree or equivalent from an accredited college or university preferred
• Six (6) years of absence management experience or equivalent combination of education and experience required
• Demonstrated progressive responsibilities strongly preferred
• Project management, office operations management, disability/absence management, insurance-related, and/or statistical analysis experience preferred
• Knowledge of legal requirements and best practices relevant to absence programs and administration
• Excellent oral and written communication, including presentation skills
• PC literacy, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Negotiation skills
• Good interpersonal skills
• Self-motivated with the ability to work independently
• Ability to work in a team environment

We offer a comprehensive benefits package, including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. The range of starting pay for this role is $48,186.00 - $55,000.00.

Job Data by YubHub.