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Last updated: 19 days ago
The Claims Examiner analyzes complex and technically challenging workers’ compensation claims, determines benefits due, manages high-exposure cases involving litigation and rehabilitation, and ensu...Show moreLast updated: 19 days ago
Claims Examiner Workers Compensation - Remote / Telecommute
Cynet SystemsRancho Cucamonga, CARemote
Full-time
The average salary range is between $ 92,200 and $ 126,050 year , with the average salary hovering around $ 106,250 year .
- rail (from $ 87,250 to $ 275,625 year)
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- chief financial officer (from $ 140,000 to $ 251,875 year)
- mortgage underwriter (from $ 101,250 to $ 250,000 year)
- psychiatrist (from $ 200,000 to $ 250,000 year)
- cfo (from $ 125,000 to $ 235,000 year)
- family physician (from $ 100,000 to $ 230,000 year)
- business development director (from $ 141,250 to $ 229,200 year)
- president (from $ 60,250 to $ 225,375 year)
- dentist (from $ 25,000 to $ 225,000 year)
- Stockton, CA (from $ 92,500 to $ 338,189 year)
- Evansville, IN (from $ 55,541 to $ 292,500 year)
- Carlsbad, CA (from $ 122,400 to $ 246,000 year)
- Stamford, CT (from $ 89,375 to $ 195,950 year)
- Broken Arrow, OK (from $ 137,100 to $ 195,950 year)
- Albuquerque, NM (from $ 83,350 to $ 187,050 year)
- Ann Arbor, MI (from $ 124,150 to $ 184,225 year)
- Garland, TX (from $ 121,254 to $ 183,780 year)
- Norwalk, CA (from $ 39,990 to $ 168,845 year)
- Madison, WI (from $ 83,238 to $ 165,800 year)
The average salary range is between $ 54,019 and $ 137,100 year , with the average salary hovering around $ 101,350 year .
Claims Examiner Workers Compensation - Remote / Telecommute
Cynet SystemsRancho Cucamonga, CA19 days ago
Job type
- Full-time
- Remote
Job descriptionBachelor’s degree preferred. Professional certification related to claims preferred. Strong communication skills (written and verbal). Analytical and interpretive skills. Strong organizational and negotiation skills. PC proficiency, including Microsoft Office. Ability to work independently and within a team. Ability to handle multiple priorities and meet deadlines. Minimum 5 years of claims management experience. Experience handling complex workers’ compensation claims. Experience managing litigation and vendor coordination. Analyze and process complex workers’ compensation claims to determine exposure and benefits due. Develop and execute action plans to ensure timely claim resolution. Negotiate settlements within designated authority limits. Assign, monitor, and adjust reserves appropriately. Approve and make claim payments and adjustments. Prepare required state filings within regulatory timeframes. Manage the litigation process to ensure cost-effective outcomes. Coordinate vendor referrals when additional investigation is needed. Apply cost-containment strategies to minimize claim expenses. Manage recoveries including subrogation and applicable offsets. Report claims to excess carriers and respond to carrier requests. Maintain accurate documentation and ensure proper claims coding. Communicate regularly with claimants and clients. Refer cases to management as needed. Strong judgment, problem-solving, and decision-making abilities. Ability to work under pressure and handle stressful situations. Ability to adapt and prioritize in a fast-paced environment. Claims handling expertise. Knowledge of insurance laws and regulations for workers’ compensation. Understanding of medical management and disability duration. Strong interpersonal and presentation skills. Bachelor’s degree preferred. Professional certification preferred. Equivalent work experience accepted in lieu of degree.
Job Description :
Pay Range : $45hr - $50hr
- The Claims Examiner analyzes complex and technically challenging workers’ compensation claims, determines benefits due, manages high-exposure cases involving litigation and rehabilitation, and ensures timely and accurate claim adjudication.
- The role includes identifying subrogation opportunities, negotiating settlements, and maintaining compliance with service expectations and industry best practices.
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