Senior Workers’ Compensation Claims Examiner

Insurance Placement Solutions (IPS) has an immediate opening for a Senior Workers’ Compensation Claims Examiner with our client in Phoenix, Arizona. This is a full-time temp-to-hire opportunity with a hybrid schedule requiring three days per week in the office.

In this role, you’ll independently manage a caseload of approximately 130 workers’ compensation claims from investigation through resolution. You’ll handle complex indemnity claims, determine compensability, manage medical treatment and benefits, establish reserves, oversee litigation, and develop strategies to move claims toward timely and cost-effective resolution.

Senior Workers’ Compensation Claims Examiner Responsibilities

Manage an average caseload of approximately 130 workers’ compensation claims, including complex indemnity files

Investigate claims and determine compensability in accordance with applicable state requirements

Develop and maintain claim action plans through resolution

Administer workers’ compensation benefits and authorize appropriate claim payments

Manage medical treatment and associated medical billing

Establish and maintain appropriate reserves throughout the life of the claim

Refer litigated matters to defense counsel and provide ongoing direction and oversight

Identify and manage claim recovery opportunities, including subrogation and deductibles

Evaluate, negotiate, and finalize claim settlements within designated authority

Maintain an effective diary system and accurate claim documentation

Conduct independent claim file reviews

Communicate claim developments and strategies with clients, claimants, providers, vendors, and other stakeholders

Ensure claims are handled in accordance with applicable regulations, client requirements, and established claims practices

Qualifications

Minimum of 5 years of workers’ compensation claims handling experience

Experience independently managing complex workers’ compensation claims

Experience handling indemnity claims from investigation through resolution

Technical knowledge of workers’ compensation statutory regulations and medical terminology

Preferred

Bachelor’s degree in a related field

Experience handling claims for self-insured programs

City, county, district, or other public entity claims experience

Proficiency with Microsoft Word and Excel

Licensing & Certifications

Appropriate adjuster license and/or certifications as required by state regulations

Work Arrangement

Temp-to-hire opportunity

Hybrid position based in Phoenix, Arizona

Three days per week in the office

About Insurance Placement Solutions

Insurance Placement Solutions is a staffing and recruiting firm specializing in the insurance industry. We connect talented professionals with temporary, temp-to-hire, and direct-hire opportunities at leading insurance organizations across the United States.

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