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Workers Compensation Claims Examiner

Workers Compensation Claims Examiner

SuretyHRColumbus, OH, US
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Spooner Incorporated is a family owned and operated company that offers rewarding career opportunities for motivated individuals who are passionate about excellence and growth.

Since 1975, Spooner’s proactive philosophy and best practices have set the standard in workers’ compensation, preventing excessive compensation and medical costs in claims while assisting employees in early, healthy return to work.

The Workers Compensation Claims Examiner is primarily responsible for analyzing and processing complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim.

Essential Functions

  • Report, investigate, manage, and resolve workers' compensation claims for assigned state(s).
  • Assists the Claims Manager in identifying claim trends and developing safety recommendations to mitigate the company's overall cost of risk.
  • Support the Risk Management department on risk-related projects.
  • Gather data for resolving claims.
  • Coordinate with medical / special investigators and vendor partners to reduce overall claims.
  • Manage the litigation process to ensure timely and effective claims resolution.
  • Participate in continuous improvement activities and other assigned duties.

Supervision Received

  • Reports to the Claims Manager Experience and Education Required
  • Associates Degree from an accredited college or university
  • One (1) year of working in the claim’s environment
  • Excellent communication and organization skills.
  • Strong computer skills with working knowledge of Word, Excel, PowerPoint, Outlook.
  • Ability to travel for work.
  • Experience and Education Preferred

  • Bachelor’s degree from an accredited college or university
  • Knowledge of medical terminology
  • Detail oriented
  • Self-motivated, accepts responsibility, and enjoys a challenge
  • Determined and focused on accomplishing tasks in a timely fashion
  • Strong interpersonal and communication skills Tools and Equipment Used The occupant is expected to freely operate the following tools and equipment :
  • personal computer (including word processing, spreadsheet, and database programs); printer; calculator; telephone; copier; fax machine.
  • Working Environment The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of the job.
  • While performing the duties of this job, the employee typically works in a normal office environment.
  • The noise level in the work environment is usually quiet.
  • Physical Demands The physical demands described herein are representative of those that must be met by an employee to successfully perform the essential functions of this job.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • While performing the duties of this job, the employee is regularly required to use hands to finger, handle, carry or operate objects, tools or controls and reach with hands and arms.
  • The employee frequently is required to stand; talk or hear; walk, sit.
  • Specific vision abilities required by this job include close vision and the ability to adjust focus.
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