Position Overview
The Workers' Compensation Claims Examiner is responsible for managing and resolving Texas workers' compensation claims while ensuring compliance with the Texas Department of Insurance–Division of Workers' Compensation (TDI-DWC). This hybrid role is based out of the Irving, TX office and offers a blend of in-office collaboration and remote work flexibility. The examiner handles investigations, benefit administration, communication with stakeholders, and settlement strategies to drive timely, fair claim resolution.
Key Responsibilities
Claims Management
Manage a caseload of Texas WC claims from initial report through resolution.
Conduct prompt, thorough investigations including recorded statements and employer interviews.
Analyze medical records, wage reports, and compensability factors to determine appropriate benefits.
Monitor treatment plans and coordinate with providers to ensure medically necessary care.
Regulatory & Compliance
Follow all requirements under the Texas Labor Code, TDI-DWC rules, and strict timeline mandates.
Issue timely notices, benefit payments, PLN forms, and other required documentation.
Maintain accurate claim files and ensure compliance with internal and external audits.
Communication & Coordination
Collaborate closely with employers, injured workers, medical providers, attorneys, and nurse case managers.
Communicate claim status and next steps clearly and professionally.
Support employers with return-to-work planning, including modified duty options.
Litigation & Legal Support
Work with defense counsel on disputed claims, benefit review conferences (BRC), and contested case hearings (CCH).
Prepare litigation summaries, evaluations, and recommendations for settlement authority.
Attend hearings (in person or virtual) when needed.
Financial & Settlement Management
Set and maintain accurate reserves based on exposure and medical progression.
Evaluate settlement opportunities and negotiate within designated authority.
Identify fraud indicators and pursue subrogation when appropriate.
Qualifications
Experience handling Texas Workers' Compensation claims required.
Strong knowledge of TDI-DWC rules, forms, deadlines, and dispute resolution processes.
Excellent communication, investigative, and negotiation skills.
Ability to work efficiently in a hybrid environment based out of Irving, TX.
Certifications such as AIC, ARM, or WCCP preferred but not required.
Workers Compensation Adjuster (TX) • Irving, TX, US
Job Description & Requirements.Uro-hospitalist Around Atlanta.StartDate: ASAP Pay Rate: $600000.Subspecialties are welcomed, and you’ll be supported by a collaborative team of.Rounding on average 1...Show more
AI labs train foundational models and enterprises build AI agents.We provide frontier evaluations and reinforcement learning environments used to improve LLM capabilities, as well as contextual eva...Show more
Baylor Scott & White Medical Center – Waxahachie, Texas.OB/GYN Hospitalist Opportunities.Baylor Scott & White Medical Center in Waxahachie.Waxahachie community since 1914.It is home to six private ...Show more
The Associate General Counsel – Labor & Employment will have litigation experience defending California wage and hour class actions and Private Attorneys General Act (PAGA) claims as well as relate...Show more
Baylor Scott & White Medical Center – Waxahachie, Texas.OB/GYN Hospitalist Opportunities.Baylor Scott & White Medical Center in Waxahachie.Waxahachie community since 1914.It is home to six private ...Show more
AlliedTravelCareers is working with Core Medical Group to find a qualified Physical Therapist (PT) in Midlothian, Texas, 76065!.Client in TX seeking Physical Therapist: Outpatient/Clinic.We are loo...Show more
Responsibilities Who We Are: Millwood Hospital (a UHS Facility) is a 134-bed mental health facility that provides inpatient and outpatient mental health and chemical dependency treatment.Millwood's...Show more
Assists attorneys with the handling of all aspects of litigation including, but not limited to, preparing discovery responses, meeting with staff to obtain necessary information and/or documents; p...Show more
Senior Workers' Compensation Claims Adjuster.Amerisure creates exceptional value for its partners, policyholders, and employees.As a property and casualty insurance company, Amerisure's promise to ...Show more
Are you a Urologist searching for a hospitalist perm position? This position with one of VISTA's healthcare partners west of Atlanta might just be the opportunity for you!.Inpatient Rounding at two...Show more
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it's our purpose.Every day, we help clients navigate complexity,...Show more
Senior Workers' Compensation Claims Adjuster.Amerisure creates exceptional value for its partners, policyholders, and employees.As a property and casualty insurance company, Amerisure's promise to ...Show more
BITCO Corporation, headquartered in Davenport, IA, is currently seeking a.Claims Specialist, Workers' Compensation.With 11 branch offices in 10 states, BITCO provides.This position is eligible for ...Show more
Workers' Compensation Claims Adjuster Location:.Arlington, TX (In-Office Position) AS&G is seeking an experienced and motivated Workers' Compensation Claims Adjuster to join our dynamic team in Arl...Show more
Join Our Team And Be Part Of Something Truly Transformational!.CareGard Warranty Services, part of Automotive Financial Group (AFG), has been redefining the automotive protection industry since 199...Show more
A leading building products distribution company in Coppell, Texas, is seeking a legal professional with a Juris Doctor (J.The role involves advising HR and executives on employment matters, suppor...Show more
Berkley Entertainment Workers Compensation Litigation Specialist.At Berkley Entertainment, we have over 25 years of underwriting risks in Entertainment & Sports.Our one focus is entertainment insur...Show more
Note : This is an educational program, not a job.Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market.Are you pas...Show more
