workers' compensation claims examiner

Sedgwick

<div><p>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
</p><p></p><p>Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
</p><p>Certified as a Great Place to Work&reg;
</p><p>Fortune Best Workplaces in Financial Services &amp; Insurance
</p><p></p>Claims Examiner - Workers Compensation I Midwest Jurisdictions
<p></p><div><p>Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world&rsquo;s best brands?
</p><ul><li>Apply your workers compensation examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</li><li>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</li><li>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</li><li>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</li><li>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</li><li>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</li><li>Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
</li></ul><p></p><p><b>PRIMARY PURPOSE OF THE ROLE: </b>We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
</p><p></p><p><b>ARE YOU AN IDEAL CANDIDATE? </b>To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
</p><p></p><p><b>ESSENTIAL RESPONSIBLITIES MAY INCLUDE
</b></p><ul><li>Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
</li><li>Negotiating settlement of claims within designated authority.
</li><li>Communicating claim activity and processing with the claimant and the client.
</li><li>Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
</li></ul><p></p><p><b>QUALIFICATIONS
</b></p><p>Education &amp; Licensing: 5 years of claims management experience or equivalent combination of education and experience required.
</p><ul><li>High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
</li><li>Professional certification as applicable to line of business preferred.
</li></ul><p></p><p>Licensing / Jurisdiction Knowledge: <b>IL, MN, IN, WI
</b></p><p></p><p><b>TAKING CARE OF YOU
</b></p><ul><li>Flexible work schedule.
</li><li>Referral incentive program.
</li><li>Opportunity to work in an agile environment.
</li><li>Career development and promotional growth opportunities.
</li><li>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
</li></ul><p></p><p>Work environment requirements include &ndash;
<br>
Physical: Computer keyboarding
<br>
Auditory/visual: Hearing, vision and talking
<br>
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
</p><p></p><p><i>As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $63,404 - $89,000/yr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always accepting applications.
</i></p></div><p></p><p>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
</p><p></p><h2 class="jobSectionHeader"><b>If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</b></h2></div>

Claims Examiner - Workers Compensation I Midwest Jurisdictions

<div><p>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
</p><p></p><p>Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
</p><p>Certified as a Great Place to Work&reg;
</p><p>Fortune Best Workplaces in Financial Services &amp; Insurance
</p><p></p>Claims Examiner - Workers Compensation | Floater on Dedicated Account | Multi State Jurisdiction | Reciprocal License preferred (Remote)
<p></p><p>Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world&rsquo;s best brands?
</p><ul><li><p>Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</p></li><li><p>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</p></li><li><p>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</p></li><li><p>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</p></li><li><p>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</p></li><li><p>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</p></li><li><p>Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs.
</p></li></ul><p></p><p><b>ARE YOU AN IDEAL CANDIDATE? </b>To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
</p><p></p><p><b>PRIMARY PURPOSE OF THE ROLE: </b>We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
</p><p></p><p><b>ESSENTIAL RESPONSIBLITIES MAY INCLUDE
</b></p><ul><li><p>Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
</p></li><li><p>Negotiates settlement of claims within designated authority.
</p></li><li><p>Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
</p></li><li><p>Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
</p></li><li><p>Prepares necessary state fillings within statutory limits.
</p></li><li><p>Manages the litigation process; ensures timely and cost effective claims resolution.
</p></li><li><p>Coordinates vendor referrals for additional investigation and/or litigation management.
</p></li><li><p>Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
</p></li><li><p>Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
</p></li><li><p>Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
</p></li><li><p>Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
</p></li><li><p>Ensures claim files are properly documented and claims coding is correct.
</p></li><li><p>Travels as required.
</p></li></ul><p></p><p><b>QUALIFICATIONS
</b></p><p>Education and Licensing
</p><p>Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
</p><p></p><p>Experience
</p><p>Five (5) years of claims management experience or equivalent combination of education and experience required.
</p><p></p><p><b>Jurisdiction Knowledge: 32 states
</b></p><p><b>Licensing: TX/ FL or reciprocal license preffered
</b></p><p></p><p><b>TAKING CARE OF YOU
</b></p><p>Flexible work schedule.
</p><p>Referral incentive program.
</p><p>Opportunity to work in an agile environment.
</p><p>Career development and promotional growth opportunities.
</p><p>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
</p><p></p><p><i>As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is </i><i>$60,234.00-$80,000.00 </i><i>. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
</i></p><p></p><p>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
</p><p></p><h2 class="jobSectionHeader"><b>If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</b></h2></div>

Claims Examiner - Workers Compensation | Floater on Dedicated Account | Multi State Jurisdiction | Reciprocal License preferred (Remote)

Athens Administrators

<div><div><b>ATHENS POSITION DETAILS</b></div>
<div></div><div><div><div><div><div><b>Position Title:</b></div>
</div><div><div>Assistant Claims Examiner</div><br>
</div></div><br>
<div><div><div><b>Department:</b></div>
</div><div><div>Workers&rsquo; Compensation</div><br>
</div></div><br>
<div><div><div><b>Reports To:</b></div>
</div><div><div>Claims Supervisor</div><br>
</div></div><br>
<div><div><div><b>FLSA Status:</b></div>
</div><div><div>Non-Exempt</div><br>
</div></div><br>
<div><div><div><b>Job Grade:</b></div>
</div><div><div>6</div><br>
</div></div><br>
<div><div><div><b>Career Ladder:
</b></div></div><div><div>Next step in progression could include Future Medical Examiner or Claims Examiner Trainee</div>
</div></div><br>
</div></div><div></div><div><b>ATHENS ADMINISTRATORS</b></div>
<div>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 a &ldquo;Best Place to Work.&rdquo; 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 &amp; Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!</div>
<div></div><div><b>POSITION SUMMARY</b></div>
<div>Athens Administrators has an immediate need for an experienced Assistant Claims Examiner to support our Workers&rsquo; Compensation department 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 &ndash; 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 Assistant Claims Examiner will provide clerical and technical assistance to Senior Claims Examiners and administer Medical Only claims, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, and setting reserves.</div>
<div></div><div><b>PRIMARY RESPONSIBILITIES</b></div>
<div>Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:</div>
<div></div><ul><li>Process new claims in compliance with client&rsquo;s Service Agreement</li>
<li>Issue all indemnity payments and awards on time</li>
<li>Process all approved provider bills timely</li>
<li>Prepare objection letters to providers for medical bills; delayed, denied, lacking reports.</li>
<li>Answer questions over the phone from medical providers regarding bills</li>
<li>Contact treating physician for disability status</li>
<li>Contact employer for return-to-work status or availability of modified work.</li>
<li>Contact injured worker at initial set up</li>
<li>Send DWC notices timely</li>
<li>Issue SJDB Notices timely</li>
<li>Request Job Description from Employer</li>
<li>Handle Medical Only claim files</li>
<li>Calculate wage statements and adjust disability rates as required</li>
<li>Keep diary for all delay dates and indemnity payments</li>
<li>Documents file activity on computer</li>
<li>Update information on computer, i.e., address changes, etc.</li>
<li>Schedule appointments for AME, QME evaluations</li>
<li>Send appointment letters, issue TD/mileage, send medical file</li>
<li>Schedule interpreter for appointments, depositions, etc.</li>
<li>Request Employer&rsquo;s Report, DWC-1, Doctor&rsquo;s First Report if needed</li>
<li>Verify mileage and dates of treatment for reimbursement to claimant</li>
<li>Subpoena records</li>
<li>File and serve documents on attorneys, WCAB, doctors</li>
<li>Serve PTP&rsquo;s with medical file and Duties of Treating Physician (9785)</li>
<li>Request PD ratings from DEU</li>
<li>Draft Stipulated Awards and C&amp;R&rsquo;s</li>
<li>Submit C&amp;R, Stipulated Awards to WCAB for approval with documentation</li>
<li>Process checks &ndash; stop payment, cancellations, void, journal payments</li>
<li>Handle telephone calls for examiner as needed</li>
<li>Complete penalty calculations and prepare penalty worksheets</li>
<li>Complete MPN, HCO and/or EDI coding</li>
<li>Complete referrals to investigators</li>
<li>Complete preparation of documents for overnight delivery</li>
<li>Work collaboratively with Senior Claims Examiners, Nurse Case Managers, and other Assistant Claims Examiners</li>
<li>Contact with clients, injured workers, attorneys, doctors, vendors, and other parties</li>
<li>Provide updates of claims status to Senior Claims Examiners and Athens management</li>
<li>Prepare professional, well written correspondence and other communications</li>
</ul>
<div></div><div><b>ESSENTIAL POSITION REQUIREMENTS
</b></div><div>The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.</div>
<ul><li>High School Diploma or equivalent (GED) required for all positions
<ul><li>AA/AS or BA/BS preferred but not required</li>
</ul></li><li>2+ years&rsquo; Claims Assistant experience supporting a workers compensation examiner or team preferred</li>
<li>Medical Only Adjuster designation required</li>
<li>Continuing hours must be current</li>
<li>Mathematical calculating skills</li>
<li>Completion of IEA or equivalent courses</li>
<li>Administrators Certificate from Self-Insurance Plans preferred</li>
<li>Knowledge of workers compensation laws, policies, and procedures</li>
<li>Understanding of medical and legal terminology</li>
<li>Must demonstrate accuracy and thoroughness in work product</li>
<li>Ability to sit for prolonged periods of time</li>
<li>Well-developed verbal and written communication skills with strong attention to detail</li>
<li>Excellent organizational skills and ability to multi-task</li>
<li>Ability to type quickly, accurately and for prolonged periods</li>
<li>Proficient in Microsoft Office Suite</li>
<li>Ability to learn additional computer programs</li>
<li>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</li>
<li>Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization</li>
<li>Seeks to include innovative strategies and methods to provide a high level of commitment to service and results</li>
<li>Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner</li>
<li>Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor</li>
<li>Athens&rsquo; 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.</li>
<li>Must be able to reliably commute to meetings and events as required by this position</li>
</ul><div><b>APPLY WITH US</b></div>
<div>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&rsquo;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</div>
<div></div><div>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.</div>
<div></div><div>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.</div>
<div></div><div><b>THANK YOU!</b></div>
<div>We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don&rsquo;t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!</div>
<div></div><div>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 &amp; 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&amp;D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA &amp; FSA options, 401k (and Roth), Company-Paid STD &amp; LTD and more! Further information about our comprehensive benefits package may be found on our website at <b>https://www.athensadmin.com/careers/why-work-here</b></div></div>

Assistant Claims Examiner

Great American Insurance Group

<div><p><b>Be Here. Be Great. </b>Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a &quot;small company&quot; culture where your ideas will be heard with &quot;big company&quot; expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.</p><p></p><p>
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.</p><p></p><p>
-</p><p>
When is the last time you felt like you made a difference to your employer and in the job you do? Been awhile? Never? Our employees at Strategic Comp DO make a difference and feel appreciated for it. In fact, we received 98% rating for overall job satisfaction from the participants in our last employee survey, clearly indicating the passion and energy our staff has for our company and for the job they do!</p><p></p><p>
Currently we have an opening for a<b> Senior Claims Specialist</b> in your territory. Are you innovative, high energy, resilient, determined, assertive, clever, and competitive? Do you see each new claim as a puzzle to work and a challenge to be won? Does this sound like you? If so, this might be the right job for you.</p><p></p><p><b>
Here&rsquo;s who we are</b>. Strategic Comp is part of Great American Insurance Group, which was established in 1872. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance focusing on specialty commercial products for businesses. The members of the Great American Insurance Group are subsidiaries of American Financial Group, Inc. AFG&rsquo;s common stock is listed and traded on the New York Stock Exchange (&ldquo;NYSE&rdquo;) and NASDAQ under the symbol &ldquo;AFG&rdquo;.</p><p></p><p><b>
Here&rsquo;s what we do</b>. We insure workers&rsquo; compensation coverage for large companies, using our deductible program. Our service in claims and loss control is second to none. We&rsquo;ve found that a large majority of our customers feel the way our employees do. Our renewal retention is 90+%, meaning they enjoy working with us too!</p><p></p><p><b>
Here&rsquo;s what you would be doing </b>if hired for the Senior Claims Specialist position. Your role would be to investigate and adjust workers' compensation claims with high potential exposure. We take an extremely aggressive and proactive approach to claims adjusting and are looking for the person who not only knows their territory&rsquo;s comp laws but also enjoys the role of putting that experience to good use. <i>Because we focus on outcomes and not just processes, we look for the adjuster who is very skilled at developing strategies to bring claims to resolution.</i> The candidate hired for this position will work from an office in their home with occasional travel to claims reviews and meetings in the Pacific Region. Candidate hired for this position will be required to work Pacific Time Zone business hours.</p><p></p><p>
Responsibilities</p><ul><li><p>
Investigating losses</p></li><li><p>
Analyzing coverage, determining compensability and benefits</p></li><li><p>
Establishing reserves and negotiating settlements</p></li><li><p>
Conducting meetings on the phone with insureds and claimants</p></li><li><p>
Preparing large loss reports to both internal and external audiences</p></li><li><p>
Attending settlement conferences as assigned</p></li><li><p>
Working closely with defense attorneys and other vendors including medical case management, surveillance, etc.</p></li></ul><p></p><p>
Physical Requirements</p><ul><li><p>
Sedentary - requires prolonged sitting, continuous use of computer</p></li><li><p>
Occasional Travel - may require overnight travel to tri-annual claim reviews and/or departmental meetings</p></li></ul><p></p><p>
Qualifications</p><ul><li><p>
Although we typically require 10+ years of experience, we will consider exceptional candidates with 7+ years of proven success in California workers' compensation claims adjusting experience with higher exposure claims</p></li><li><p>
Current license to adjust workers&rsquo; compensation claims in California is required</p></li><li><p>
Ability to work Pacific Time Zone business hours is required</p></li><li><p>
Strong consideration will be given to candidates with industry designations including Associate in Claims</p></li><li><p>
You must be a great communicator, in both written and verbal form, and be able to work with a variety of internal and external contacts</p></li></ul><p></p><p>
#LI-StrategicComp</p><p></p><p><b>
Business Unit:</b></p>
Strategic Comp<p></p><p><b><br>
Salary Range:</b></p>
$110,000.00 -$120,000.00<p></p><p><b>
Benefits:</b></p><p>
We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.</p><p></p><p><br>
Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.</p><p></p><ul><li><br>
<b>Excludes seasonal employees and interns.</b></li></ul></div>

Senior Claims Specialist - CA Workers' Compensation

State of Utah

<p></p><div><p><b>Claims Examiner I, Career Service Exempt</b></p><p><b>
FT / PT Status &ndash; </b>Full-Time<br>
<b>Salary &ndash; </b>$18.00 - $31.61 Hourly Wage
<br>
<b>Remote Work / In-Office &ndash; </b>Hybrid (After ample training, may qualify for hybrid/remote)<br>
<br>
<b>Recruiter &ndash; </b>Liz Vander Linden | evander@utah.gov | 801-957-7232<br>
<b>Application Deadline &ndash; </b>4/26/2026</p><p></p><p><b><br>
Key Responsibilities</b></p><p><br>
The Utah Unclaimed Property Division seeks a full-time Claims Examiner I, Career Service Exempt to join our committed, creative, and enthusiastic team. We return tens of millions of dollars of unclaimed property to rightful owners every year.<br>
Our next Claims Examiner I will assist many Utahns in recovering their lost money. Some claims are very easy and others are like solving a huge puzzle to determine who is the rightful owner. Look us up at: mycash.utah.gov.</p><p>
Please note this is an entry level position.</p><p>
Do you:</p><ul><li>
Strive for accuracy and precision?</li><li>
Perform best with clear direction, rules, and structure?</li><li>
Enjoy being a resource of knowledge &amp; information for others?</li><li>
Embrace opportunities to work independently?</li><li>
Relish Solving problems and pivoting to meet the current need?</li><li>
Avoid chaos and drama and instead focus on facts and data?</li><li>
Prefer to work alone on tasks rather than in a group?</li><li>
Are you a skeptical person who requires volumes of information before forming a firm opinion?</li><li>
Find that your communication style is more informative and factual than socially oriented?</li><li>
Possess a natural sense of urgency &amp; move quickly between tasks?</li><li>
Communicate directly, factually &amp; in a no-nonsense manner?</li><li>
Desire change, new challenges, &amp; variety over routine?</li><li>
Perform better in an orderly work environment that is free of clutter?</li></ul><p>
If this is you, we should talk.</p><p>
First, go to this page: https://go.cultureindex.com/p/n6hu69Wz715hd3rCdf1H to take a quick 8-10 minute survey and attach your resume.</p><p>
If we determine that you are a great fit, we will follow up with more information and a full description of responsibilities and benefits.</p><p></p><p><b><br>
About the Role</b></p><p><b>
Location</b> &ndash;
<br>
168 North 1950 West, Suite 102<br>
Salt Lake City, UT, 84116<br>
United States
<br>
<b>Background Check Required</b> &ndash; No<br>
<b>Drug Test Required</b> &ndash; No
<br>
<b>Schedule Code</b> &ndash; AC - Employees in Offices of Elected Officials</p><p><b>
Schedule: Monday - Friday 8 hour shift</b></p><p><b>
Why You Should Join Our Team</b><br>
In Utah, we believe hard work is important, but balance is essential. Finding work/life balance is a vital element to our culture. To find out more about WHY Utah, click here. Other benefits may include:</p><ul><li><b>
Job Stability: </b>Enjoy the security and reliability of employment within a well-established organization.</li><li><b>
Career Growth:</b><b> </b>Develop valuable skills and gain opportunities for leadership within a large organization.</li><li><b>
Meaningful Work: </b>Contribute to an important service that benefits the community and supports organizational goals.</li><li><b>
Supportive Work Environment:</b><b> </b>Be part of a team that values cooperation, strong work ethics, and mutual support.</li></ul><p><b>
The Agency</b><br>
Millions of dollars in lost or unclaimed money are turned over to the State of Utah every year. This money comes from places like dormant bank accounts, old stock certificates, and uncollected insurance checks. This is the official government website for managing and returning this unclaimed property to the residents of Utah.</p><p><b>
EEO Statement</b><br>
The State of Utah is committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. For accommodations, please contact (801) 957-9390.</p></div><div></div>

Claims Examiner I, Career Service Exempt

Markel Corporation

<div><p>What part will you play? If you&rsquo;re looking for a place where you can make a meaningful difference, you&rsquo;ve found it.
</p>The work we do at Markel gives people the confidence to move forward and seize opportunities, and you&rsquo;ll find your fit amongst our global community of optimists and problem-solvers. We&rsquo;re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs.&amp;#xa;&amp;#xa;Join us and play your part in something special!&amp;#xa;&amp;#xa;This position will be responsible for the resolution of high complexity and high exposure Workers Compensation claims in multiple jurisdictions. The position will have increased responsibility for decision making within their authority and work under general direction from their manager.
<p></p><p><b>Job Responsibilities
</b></p><ul><li>Confirms coverage of claims by reviewing policies and documents submitted in support of claims
 </li><li>Analyzes coverage and communicates coverage positions
</li><li>Conducts, coordinates, and directs investigation into loss facts and extent of damages
</li><li>Directs and monitors assignments to experts and outside counsel
</li><li>Evaluates information on coverage, compensability, and medical management to determine the extent of insured's exposure
</li><li>Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
</li><li>Focus on driving claims to a resolution with a focus of returning the injured back to work
</li><li>Evaluate, Negotiate and settle claim when appropriate
</li><li>Prepares reports by collecting and summarizing information
</li><li>Adheres to Fair Claims Practices regulations and internal Claims Quality Performance Objectives
</li><li>Participates in special projects or assists other team members as requested
</li><li>Attend all state specific trainings as scheduled
</li><li>Travel to mediations, trials, and conferences as required
</li></ul><p></p><p><b>Requirements
</b></p><ul><li><p>A degree in business related courses optional in exchange for experience in insurance.
</p></li><li><p>An insurance designation is a plus.
</p></li><li><p>Excellent written and oral communication skills
</p></li><li><p>Strong analytical and problem solving skills
</p></li><li><p>Strong organization and time management skills
</p></li><li><p>Ability to deliver outstanding customer service
</p></li><li><p>Strong knowledge and understanding of medical terminology is a plus.
</p></li><li><p>Intermediate skills in Microsoft Office products (Excel, Outlook, Power Point, Word)
</p></li><li><p>Ability to work in a team environment
</p></li><li><p>Strong desire for continuous improvement
</p></li></ul><p></p><p><b>US Work Authorization
</b></p><p></p><p>US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future.
</p><p></p><div><div><p><b>Who we are:
</b></p></div><div><p>Markel Group (NYSE &ndash; MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world.<br>
</p></div><p></p><div><p><b>We&rsquo;re </b><b>all about people | We win together | We strive for better<br>
</b></p></div><p></p><div><p><b>We enjoy the everyday | We think further<br>
</b></p></div><p></p><div><p><b>What&rsquo;s </b><b>in it for you:
</b></p></div><p></p><div><p>In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work.
</p></div><div><ul><li><p>We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees&rsquo; needs at all stages of life.
</p></li></ul></div><div><ul><li><p>All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&amp;D insurance.
</p></li></ul></div><div><ul><li><p>We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave.<br>
</p></li></ul></div><p></p><div><p><b>Are you ready to play your part?
</b></p></div><p></p><div><p>Choose <b>&lsquo;Apply Now&rsquo; </b>to fill out our short application, so that we can find out more about you.<br>
</p></div></div><p></p><div><div><p><b>Caution: Employment </b><b>scams
</b></p></div><p></p><div><p>Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These &quot;job offers&quot; include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that:
</p></div><div><ul><li><p>All legitimate job postings with Markel will be posted on Markel Careers . No other URL should be trusted for job postings .
</p></li></ul></div><div><ul><li><p>All legitimate communications with Markel recruiters will come from Markel.com email addresses.<br>
</p></li></ul></div><p></p><div><p>We would also ask that you please report any job employment scams related to Markel to rarecruiting@markel.com .<br>
</p></div><p></p><div><p>Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law.<br>
</p><p></p><p>Should you require any accommodation through the application process, please send an e-mail to the rarecruiting@markel.com .
</p><p></p><p>No agencies please.</p></div></div></div>

Claims Examiner III, Workers Compensation

DOCTORS HEALTHCARE PLANS, INC.

<div><p>The<b> Claims Examiner III </b>is a senior-level claims professional responsible for the accurate and timely adjudication of complex professional and institutional claims in accordance with regulatory requirements, contractual agreements, and internal policies. This role supports departmental workflow oversight, assists leadership with productivity and quality monitoring, and serves as a subject matter resource to team members to ensure operational excellence and compliance with CMS and organizational standards.<br>
<br>
<b>Key Responsibilities:</b></p><div><ul><li>
Review, analyze, and adjudicate professional and institutional claims, including high-dollar and complex cases.</li><li>
Process Member Reimbursement claims in accordance with plan benefits and regulatory guidelines.</li><li>
Ensure claims are processed accurately, timely, and in compliance with CMS regulations, state guidelines, and internal policies.</li><li>
Assist the Claims Manager and/or Assistant Director in monitoring daily, weekly, and monthly workflow to meet production and quality targets.</li><li>
Generate and analyze reports to track productivity, aging inventory, and pending items.</li><li>
Provide guidance and clarification to team members regarding claims processing rules, contract interpretation, and system functionality.</li><li>
Support the implementation and enforcement of departmental policies and procedures.</li><li>
Collaborate with leadership to ensure production, accuracy, and turnaround time metrics are consistently met.</li><li>
Communicate departmental goals, workflow strategies, and performance improvement initiatives to staff.</li><li>
Promote a positive work environment that supports staff engagement, accountability, and teamwork.</li><li>
Maximize system capabilities by ensuring proper utilization of claims processing tools and platforms.</li><li>
Identify process improvement opportunities and escalate system or configuration issues as needed.</li><li>
Perform additional duties as assigned.</li></ul><div><b>
Qualifications:</b></div></div><ul><li>
High School Diploma or GED</li><li>
Minimum of 3+ years of experience as a Medical Claims Examiner.</li><li>
Experience processing Medicare Advantage and/or managed care claims preferred.</li><li>
Strong experience with contract interpretation and benefit application.</li><li>
Working knowledge of CMS guidelines, Medicare regulations, and healthcare claims processing standards.</li><li>
Strong analytical and problem-solving skills.</li><li>
Proficiency in Windows-based systems and claims processing applications.<br>
</li></ul><div><i>
Note: This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s). Duties described are not to be interpreted as being all-inclusive or specific to any individual team member.</i></div><p><i>
No Third Party Agencies or Submissions Will Be Accepted.</i><br>
<br>
<i>Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP</i><br>
<br>
<i>Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein.</i></p><p>
</p><p>3hOLMnYaLt</p></div>

Claims Examiner III

Search 10000+ Workers' compensation claims examiner jobs near you this May. New roles added regularly across leading industries. Apply today.