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Job Requirements of Claims Examiner - Workers Compensation:
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Employment Type:
Contractor
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Location:
Alaiedon Township, MI (Onsite)
Do you meet the requirements for this job?
Claims Examiner - Workers Compensation
Position Title: Claims Examiner - Workers Compensation (Remote) Locations: Lansing, MI 48909
Anticipated Start Date: 07/28
Expected Duration: 2 Months
Job Type: Contract with possible extension
Pay Rate $43.00/hr on W2.
Need: Minimum of 5 years of workers' compensation claims management experience required.Minimum 3+ years of experience specifically handling loss time workers' compensation claims is mandatory.
Job Title:
Position Summary
We are seeking an experienced Workers' Compensation Claims Specialist to manage complex and high-exposure workers' compensation claims remotely. The ideal candidate will have a minimum of 3 years of hands-on experience handling loss time claims, with a strong understanding of litigation, rehabilitation, and subrogation processes.
This role is critical in ensuring timely and accurate adjudication of claims, in alignment with service expectations, industry best practices, and client-specific requirements.
Primary Purpose
To analyze and manage complex or technically difficult workers' compensation claims, determining benefits due, managing litigation and rehabilitation, ensuring proper adjudication, identifying subrogation opportunities, and negotiating settlements within designated authority.
Essential Functions & Responsibilities
- Investigate, analyze, and process complex workers' compensation claims to determine exposure and liability.
- Develop and implement effective action plans to resolve claims in a timely and cost-efficient manner.
- Negotiate settlements within assigned authority and recommend complex settlements to management.
- Calculate and assign appropriate claim reserves, ensuring ongoing reserve adequacy.
- Approve and process timely benefit payments and claim adjustments.
- Prepare and submit required state filings within statutory deadlines.
- Manage the litigation process to ensure favorable and cost-effective outcomes.
- Coordinate with external vendors for investigation, medical review, legal representation, and other claim-related services.
- Apply cost containment strategies, including strategic vendor partnerships, to reduce claim costs.
- Manage claim recoveries through subrogation, Second Injury Fund claims, and Social Security/Medicare offsets.
- Report claims to excess carriers and respond promptly to requests for direction.
- Communicate regularly with claimants, employers, and legal counsel to ensure transparency and satisfaction.
- Maintain accurate and organized claim files with correct coding and documentation.
- Escalate complex or high-risk cases to management as appropriate.
Additional Responsibilities
- Perform other duties as assigned.
- Support and participate in organizational quality improvement initiatives.
- Travel may be required based on business needs.
Qualifications
Education & Licensing:
- Bachelor's degree from an accredited college or university preferred.
- Professional certification (e.g., CPCU, ARM, or CWCP) preferred.
- Minimum of 5 years of workers' compensation claims management experience required.
- Equivalent combination of education and experience may be considered.
- Minimum 3+ years of experience specifically handling loss time workers' compensation claims is mandatory.
- Subject matter expert in workers' compensation laws, benefits, and procedures.
- In-depth knowledge of subrogation, offsets, disability duration, and cost containment strategies.
- Familiarity with Social Security and Medicare offset calculations.
- Strong analytical, interpretive, and problem-solving skills.
- Excellent negotiation, communication (oral and written), and presentation abilities.
- Proficient in Microsoft Office and claims management systems.
- Strong organizational and time management skills.
- Ability to work effectively in a team environment and independently.
- Commitment to meeting or exceeding service level expectations.
Work Environment
- Primarily remote; may require occasional travel for meetings or claim-related activities.
- Mental: Requires clear thinking, sound judgment, multitasking, and stress management.
- Physical: Regular computer use and keyboarding.
- Visual/Auditory: Requires normal hearing, vision, and verbal communication.
Additional Requirements
- Must pass a credit background check for security clearance.
Note: The above statements are intended to describe the general nature and level of work being performed by the person assigned to this position. They are not exhaustive lists of all duties and responsibilities. Management reserves the right to modify, add, or remove duties at any time.
Benefits:
BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.
About BCforward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.
BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.
To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.
This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.
Interested candidates please send resume in Word format Please reference job code 240913 when responding to this ad.