Athens Administrators
Senior Claims Examiner – Athens Administrators
Join to apply for the
Senior Claims Examiner
role at
Athens Administrators .
Pay range: $49.00/hr – $55.00/hr. This range is provided by Athens Administrators. Your actual pay will be based on your skills and experience—talk with your recruiter to learn more.
Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor FLSA Status: Non‑Exempt Job Grade: 12 Career Ladder: Next step could include Lead Senior Claims Examiner or Claims Supervisor
Athens Administrators – a family‑owned company since 1976, we foster an inclusive culture and offer continuous professional growth. The position is full‑time and can be located anywhere in the state of California. Employees who live less than 26 miles from the Concord or Orange offices must work once a week in the office Tuesday–Thursday. Remaining days can be remote if technical requirements are met.
The Senior Claims Examiner will adjust workers’ compensation claims from inception to settlement and closure, ensuring timely processing of claims and payment of benefits, managing medical treatment, setting reserves, and negotiating settlements.
Primary Responsibilities
Establish contact with employer to review issues
Respond to inquiries from employer, employee, doctors, and attorneys
Establish and maintain appropriate reserves
Review legal correspondence and medical reports
Evaluate and approve medical procedures and treatment
Administer benefits and ensure appropriateness of all payments
Investigate coverage, liability, and monetary value of claim
Review medical and legal bills for appropriateness
Discuss appropriateness of medical treatment with medical case manager
Determine compensability
Monitor and assist litigation
Negotiate settlement of claim, liens, rehabilitation plans, etc.
Prepare and present reports to clients
Appropriately close claims
Help resolve client billing and payment inquiries
Investigate complaints from injured workers
Document and code the claim files and claims system with all relevant information
Maintain and update action plans within specified time frames
Provide direction to Claims Assistants and Claims Technicians and assist with training, coaching, and mentoring
Provide customer service and support to clients and claimants
Work collaboratively with attorneys to draft settlements and assist with litigation strategies
Authorize and negotiate cost of medical treatment and supplies
Internal communication with staff
Prepare professional, well‑written correspondence and other communications
Essential Position Requirements
High School Diploma or equivalent (GED) required;
AA/AS or BA/BS preferred but not required;
Administrators Certificate from Self‑Insurance Plans required within one year if not already obtained;
Current Experienced Indemnity Claims Adjuster Designation;
3+ years recent workers compensation claims handling experience required;
At least 5 years of workers compensation claims experience preferred;
Solid knowledge of workers compensation laws, policies, procedures;
Completion of IEA or equivalent courses;
Proficiency in determining case value and negotiating settlements;
Understanding of medical and legal terminology;
Mathematical calculating skills;
Well‑developed verbal and written communication skills with strong attention to detail;
Excellent organizational and multi‑tasking abilities;
Typing speed: quickly, accurately, for prolonged periods;
Proficient in Microsoft Office Suite (and willingness to learn additional programs);
Reasoning, problem‑solving, and analytical skills;
Trustworthy, dependable, team‑oriented, and innovative;
Ability to maintain confidentiality of sensitive information;
Occasional in‑office meetings or file reviews as required.
How to Apply Submit your résumé and application directly through our website:
Athens Administrators Careers . Feel free to include a cover letter.
Equal Opportunity Athens Administrators is an Equal Opportunity/Affirmative Action employer. We provide equal employment opportunities to all qualified applicants. We prohibit discrimination in any employment decision.
#J-18808-Ljbffr
Senior Claims Examiner
role at
Athens Administrators .
Pay range: $49.00/hr – $55.00/hr. This range is provided by Athens Administrators. Your actual pay will be based on your skills and experience—talk with your recruiter to learn more.
Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor FLSA Status: Non‑Exempt Job Grade: 12 Career Ladder: Next step could include Lead Senior Claims Examiner or Claims Supervisor
Athens Administrators – a family‑owned company since 1976, we foster an inclusive culture and offer continuous professional growth. The position is full‑time and can be located anywhere in the state of California. Employees who live less than 26 miles from the Concord or Orange offices must work once a week in the office Tuesday–Thursday. Remaining days can be remote if technical requirements are met.
The Senior Claims Examiner will adjust workers’ compensation claims from inception to settlement and closure, ensuring timely processing of claims and payment of benefits, managing medical treatment, setting reserves, and negotiating settlements.
Primary Responsibilities
Establish contact with employer to review issues
Respond to inquiries from employer, employee, doctors, and attorneys
Establish and maintain appropriate reserves
Review legal correspondence and medical reports
Evaluate and approve medical procedures and treatment
Administer benefits and ensure appropriateness of all payments
Investigate coverage, liability, and monetary value of claim
Review medical and legal bills for appropriateness
Discuss appropriateness of medical treatment with medical case manager
Determine compensability
Monitor and assist litigation
Negotiate settlement of claim, liens, rehabilitation plans, etc.
Prepare and present reports to clients
Appropriately close claims
Help resolve client billing and payment inquiries
Investigate complaints from injured workers
Document and code the claim files and claims system with all relevant information
Maintain and update action plans within specified time frames
Provide direction to Claims Assistants and Claims Technicians and assist with training, coaching, and mentoring
Provide customer service and support to clients and claimants
Work collaboratively with attorneys to draft settlements and assist with litigation strategies
Authorize and negotiate cost of medical treatment and supplies
Internal communication with staff
Prepare professional, well‑written correspondence and other communications
Essential Position Requirements
High School Diploma or equivalent (GED) required;
AA/AS or BA/BS preferred but not required;
Administrators Certificate from Self‑Insurance Plans required within one year if not already obtained;
Current Experienced Indemnity Claims Adjuster Designation;
3+ years recent workers compensation claims handling experience required;
At least 5 years of workers compensation claims experience preferred;
Solid knowledge of workers compensation laws, policies, procedures;
Completion of IEA or equivalent courses;
Proficiency in determining case value and negotiating settlements;
Understanding of medical and legal terminology;
Mathematical calculating skills;
Well‑developed verbal and written communication skills with strong attention to detail;
Excellent organizational and multi‑tasking abilities;
Typing speed: quickly, accurately, for prolonged periods;
Proficient in Microsoft Office Suite (and willingness to learn additional programs);
Reasoning, problem‑solving, and analytical skills;
Trustworthy, dependable, team‑oriented, and innovative;
Ability to maintain confidentiality of sensitive information;
Occasional in‑office meetings or file reviews as required.
How to Apply Submit your résumé and application directly through our website:
Athens Administrators Careers . Feel free to include a cover letter.
Equal Opportunity Athens Administrators is an Equal Opportunity/Affirmative Action employer. We provide equal employment opportunities to all qualified applicants. We prohibit discrimination in any employment decision.
#J-18808-Ljbffr