Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures. Report over-payments, underpayments, and other irregularities. The Workers Compensation Examiner confer with legal counsel on claims requiring litigation.
• Must have recent workers’ compensation claims handling experience to qualify • Will working under limited supervision, review Workers’ Compensation Insurance Claims and policy information to provide background for investigation. • Contact, interview and obtain statements (recorded or in person) from the insured, claimants, witnesses, physicians, attorneys, police officers, etc., to secure necessary claim information. • Evaluate information gained via investigation to determine level of compensation and financial exposure of the account, and/or company obligation to the insured based on the policy and contracts. • Will prepare reports on investigation, settlements, denial of claims, individual evaluation of involved parties, etc.
The Workers Compensation Claims Examiner, must have experience with self insured insurance claims and 5-10 years of experience. Need to be technically strong and able to handle fast paced environment. Company offers three weeks paid vacation.