Pacific ExecSearch
Workers Compensation Claims Examiner
Pacific ExecSearch - Granite Bay, California, United States, 95746
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Overview
Job Description
We are recruiting for a Workers Compensation Claims Examiner to join a professional services organization in the Roseville area. This is a long-term contract (2025-2026) to work with a company renowned for delivering high-quality workers compensation service in the healthcare industry. The Claims Examiner is responsible for managing a complex case load of workers' compensation claims. The qualified candidate will have at least five years of experience as a workers' compensation examiner, excellent technical knowledge of worker's compensation law, strong analytical skills, and an active SIP license. This position is Hybrid ( 3 days onsite), M-F, 37.50 hours/week. Claims Examiner (No SIP) Pay range: $32-39/hour DOE Senior Claims Examiner (with SIP) | Pay range: $42-52/hour DOE
PRIMARY RESPONSIBILITIES: Review and analyze all aspects of a claim-including medical, legal, and factual details-to determine compensability and guide resolution strategies. Manage communications, documentation, and workflow (e.g., diary, payments, notices) to drive timely and financially sound claim outcomes. Establish reserves and negotiate settlements within authority level, factoring full potential exposure and reporting requirements. Engage independent medical evaluations and legal counsel as needed, directing case strategy on issues like depositions and discovery. Share expertise with colleagues, contribute to training, and represent the company in legal proceedings and industry engagements.
SKILLS AND QUALIFICATIONS: High school diploma or GED required; bachelor's degree preferred. Minimum of 5 years' experience as a workers' compensation examiner. SIP license highly desired and preferred (Senior level required SIP). Proficient in investigation, reserving, cost analysis, case resolution, and recognizing insufficient reserves to report appropriately. Able to analyze complex data, anticipate and solve problems, and use Microsoft Office along with learning specialized software systems. Demonstrated ability to manage multiple projects simultaneously with strong time management and prioritization skills. Communicates professionally and courteously across various stakeholders, maintains confidentiality, and thrives in both team-based and independent work settings.
We are recruiting for a Workers Compensation Claims Examiner to join a professional services organization in the Roseville area. This is a long-term contract (2025-2026) to work with a company renowned for delivering high-quality workers compensation service in the healthcare industry. The Claims Examiner is responsible for managing a complex case load of workers' compensation claims. The qualified candidate will have at least five years of experience as a workers' compensation examiner, excellent technical knowledge of worker's compensation law, strong analytical skills, and an active SIP license. This position is Hybrid ( 3 days onsite), M-F, 37.50 hours/week. Claims Examiner (No SIP) Pay range: $32-39/hour DOE Senior Claims Examiner (with SIP) | Pay range: $42-52/hour DOE
PRIMARY RESPONSIBILITIES: Review and analyze all aspects of a claim-including medical, legal, and factual details-to determine compensability and guide resolution strategies. Manage communications, documentation, and workflow (e.g., diary, payments, notices) to drive timely and financially sound claim outcomes. Establish reserves and negotiate settlements within authority level, factoring full potential exposure and reporting requirements. Engage independent medical evaluations and legal counsel as needed, directing case strategy on issues like depositions and discovery. Share expertise with colleagues, contribute to training, and represent the company in legal proceedings and industry engagements.
SKILLS AND QUALIFICATIONS: High school diploma or GED required; bachelor's degree preferred. Minimum of 5 years' experience as a workers' compensation examiner. SIP license highly desired and preferred (Senior level required SIP). Proficient in investigation, reserving, cost analysis, case resolution, and recognizing insufficient reserves to report appropriately. Able to analyze complex data, anticipate and solve problems, and use Microsoft Office along with learning specialized software systems. Demonstrated ability to manage multiple projects simultaneously with strong time management and prioritization skills. Communicates professionally and courteously across various stakeholders, maintains confidentiality, and thrives in both team-based and independent work settings.