Athens Administrators
Join to apply for the
Senior Claims Examiner
role at
Athens Administrators .
Athens Administrators provided pay range 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.
Base pay range $50.00/hr - $56.00/hr
Athens Position Details Position Title:
Senior Claims Examiner Department:
Workers’ Compensation California Reports To:
Claims Supervisor FLSA Status:
Non-Exempt Job Grade:
12 Career Ladder:
Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor
ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as "Best Place to Work." Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family‑owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!
Position Summary Athens Administrators has an immediate need for a full‑time Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule.
The Senior Claims Examiner will adjust workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements.
Primary Responsibilities
Establish contact with employer to review issues
Respond to inquiries from the 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 as needed for them to support daily claims tasks
Contact with employers, employees, attorneys, doctors, vendors, and other parties
Provide customer service and support to clients and claimants
Work collaboratively with attorneys to draft settlements and assist with litigation strategies
Negotiate settlements
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 for all positions
AA/AS or BA/BS preferred but not required
Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained
Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f)
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, and 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 skills and ability to multi‑task
Ability to type quickly, accurately and for prolonged periods
Proficient in Microsoft Office Suite
Ability to learn additional computer programs
Reasoning ability, including problem‑solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
Ability to be trustworthy, dependable, and team‑oriented for fellow employees and the organization
Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company
Must be able to reliably commute to meetings and events as required by this position
APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at
http://www.athensadmin.com/careers/job-openings . Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in‑house Corporate Recruitment team. The company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link:
https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf .
This description portrays in general terms the type and levels of work performed and is not intended to be all‑inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self‑education, prior experience, or on‑the‑job training.
Athens Administrators is an Equal Opportunity/Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
Referrals increase your chances of interviewing at Athens Administrators by 2x.
Get notified about new Senior Claims Examiner jobs in
California, United States .
Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company‑Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at
https://www.athensadmin.com/careers/why-work-here .
Seniority level
Mid‑Senior level
Employment type
Full‑time
Job function
Finance and Sales
Insurance
#J-18808-Ljbffr
Senior Claims Examiner
role at
Athens Administrators .
Athens Administrators provided pay range 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.
Base pay range $50.00/hr - $56.00/hr
Athens Position Details Position Title:
Senior Claims Examiner Department:
Workers’ Compensation California Reports To:
Claims Supervisor FLSA Status:
Non-Exempt Job Grade:
12 Career Ladder:
Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor
ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as "Best Place to Work." Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family‑owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!
Position Summary Athens Administrators has an immediate need for a full‑time Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule.
The Senior Claims Examiner will adjust workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements.
Primary Responsibilities
Establish contact with employer to review issues
Respond to inquiries from the 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 as needed for them to support daily claims tasks
Contact with employers, employees, attorneys, doctors, vendors, and other parties
Provide customer service and support to clients and claimants
Work collaboratively with attorneys to draft settlements and assist with litigation strategies
Negotiate settlements
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 for all positions
AA/AS or BA/BS preferred but not required
Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained
Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f)
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, and 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 skills and ability to multi‑task
Ability to type quickly, accurately and for prolonged periods
Proficient in Microsoft Office Suite
Ability to learn additional computer programs
Reasoning ability, including problem‑solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
Ability to be trustworthy, dependable, and team‑oriented for fellow employees and the organization
Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company
Must be able to reliably commute to meetings and events as required by this position
APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at
http://www.athensadmin.com/careers/job-openings . Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in‑house Corporate Recruitment team. The company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link:
https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf .
This description portrays in general terms the type and levels of work performed and is not intended to be all‑inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self‑education, prior experience, or on‑the‑job training.
Athens Administrators is an Equal Opportunity/Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
Referrals increase your chances of interviewing at Athens Administrators by 2x.
Get notified about new Senior Claims Examiner jobs in
California, United States .
Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company‑Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at
https://www.athensadmin.com/careers/why-work-here .
Seniority level
Mid‑Senior level
Employment type
Full‑time
Job function
Finance and Sales
Insurance
#J-18808-Ljbffr