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Workers' Compensation Claims Examiner
Workers' Compensation Claims ExaminerAmergis Healthcare Staffing • Columbia, MD, US
Workers' Compensation Claims Examiner

Workers' Compensation Claims Examiner

Amergis Healthcare Staffing • Columbia, MD, US
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Claims Examiner Workers' Comp I

The Claims Examiner Workers' Comp I monitors claims and makes decisions on reserve adjustments, plans of action, and closure of non-litigated claims.

Essential Duties and Responsibilities :

  • Handles new Workers' Compensation claims to resolution
  • Participates in conference calls with local offices, third-party administrators (TPAs), medical providers, and other Amergis employees to communicate status plans
  • Monitors TPA's file resolution plans
  • Controls all financial aspects of assigned claims files, including reserves per the TPA service agreement in consultation with the WC Manager
  • Coordinates claims with Claims Examiner III or designee in the event of litigation
  • Monitors lost time and transitional duty opportunities
  • Escalate reserve requests to Claims Examiner III or designee
  • Coordinates with Benefits during employee's absence
  • Coordinates with state programs and internal departments for transitional duty
  • Educates branch offices about all aspects of Workers' Compensation
  • Assists Workers' Compensation Manager in achieving overall department goals
  • Performs other duties as assigned / necessary

Minimum Requirements :

  • At least two (2) years of Workers' Compensation experience preferred
  • Some legal or insurance claims experience strongly preferred
  • College degree preferred; work experience will be considered
  • Good organizational skills and attention to detail
  • Ability to work independently and cooperatively in a team environment
  • Ability to effectively elicit / provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills required; proficiency in the English language is required
  • Proficiency with Microsoft Office applications
  • Prior experience performing internet research
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    Claim Examiner • Columbia, MD, US

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