Claims Examiner ? Workers Compensation

BCForward is currently looking for Claims Examiner - Workers Compensation - Remote

Job Title: Claims Examiner - Workers Compensation

Location: Remote
Duration: 2-Month Contract
Pay Rate: $43.00/hr (W2)

Position Summary:

We are seeking an experienced Workers' Compensation Claims Examiner to manage complex and high-exposure claims. The ideal candidate will have at least 3+ years of hands-on experience in lost time workers' compensation claims. This role involves analyzing, investigating, and resolving claims in accordance with best practices, statutory requirements, and client guidelines.

Key Responsibilities:

• Analyze and manage complex or technically challenging workers' compensation claims.
• Investigate claims thoroughly to determine benefit eligibility and exposure.
• Develop and implement action plans for effective claim resolution.
• Accurately calculate and assign reserves; monitor and adjust as needed.
• Approve and process timely claim payments and settlements within authority limits.
• Prepare and file required state forms and documents within statutory deadlines.
• Manage litigation process and coordinate with legal counsel as necessary.
• Identify opportunities for cost containment and subrogation recoveries.
• Maintain accurate documentation, ensure proper claim coding and file integrity.
• Maintain communication with claimants, clients, vendors, and internal teams.
• Ensure compliance with client service expectations and regulatory standards.

Additional Duties:

• Support organizational quality and compliance initiatives.
• May require occasional travel.
• Perform other duties as assigned.

Qualifications:

Education & Certifications:

• Bachelor's degree preferred.
• Professional certifications in claims or insurance (e.g., SIP, AIC) are a plus.

Experience:

• Minimum 3+ years of workers' compensation claims handling experience is required.
• Experience handling lost time and litigated claims is essential.

Skills:

• In-depth knowledge of workers' compensation laws, procedures, and cost containment strategies.
• Strong analytical and problem-solving skills.
• Excellent written and verbal communication.
• Proficiency with Microsoft Office and claims management systems.
• Strong negotiation, organization, and interpersonal abilities.
• Ability to work independently and collaboratively in a remote environment.

Interested candidates please send resume in Word format Please reference job code 240230 when responding to this ad.