Workers&#x27; Compensation Claims Examiner II

Gibrid To‘liq stavka O‘rta daraja Senior Talab Qilinadigan Til: inglizcha Sug‘urta da’volari bo‘yicha mutaxassis

Texas

70 000 $ – 75 000 $ / yil

Tavsif

Oversee approximately 150–180 moderate-to-complex workers’ compensation claims
Manage indemnity claims from initial assignment through resolution in line with authority limits and company or client guidelines
Calculate and set claim reserves
Approve payments and settlements within delegated authority
Recognize and escalate high-exposure claims, unusual compensability issues, sensitive client matters, and decisions beyond assigned authority
Refer claims to defense counsel when appropriate
Track litigation activity
Discuss significant legal developments and settlement strategy with the supervisor
Apply independent judgment to routine and complex claims decisions
Obtain supervisory direction for unusual, high-exposure, or sensitive claims

Talablar

High school diploma or GED
Bachelor’s degree in a related discipline preferred
Three to five years of relevant experience, or an equivalent combination of education and experience
Working knowledge of statutory regulations and medical terminology
Strong analytical ability
Excellent written and verbal communication skills, including the ability to explain technical information to claimants, clients, and staff
Ability to work effectively with people at all levels of a business organization
Ability to independently manage highly complex claims effectively
Proficiency with Microsoft Word and Excel preferred
State-required certification or licensure

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