Workers Comp Claims Examiner III – Irving, TX

Job Title:

Workers’ Compensation Claims Examiner III
- Texas Claims

Job

Location:

Irving, Texas
- On-site / Hybrid if outside the DFW metroplex

Our client is seeking an experienced Workers’ Compensation Claims Examiner to independently manage highly complex, litigated, and high-exposure indemnity claims in the Texas jurisdiction. Working under minimal supervision, you will apply advanced technical knowledge and judgment to evaluate difficult claims issues, direct defense counsel, and develop resolution strategies within assigned authority and company and client guidelines.

• Independently manage approximately 125-150 workers’ compensation claims, emphasizing highly complex, litigated, and high-exposure indemnity files.
• Evaluate difficult compensability, medical, disability, and litigation issues and develop appropriate resolution strategies.
• Establish and adjust reserves and authorize payments and settlements within assigned authority.
• Direct defense counsel and evaluate litigation strategy, significant legal developments, and settlement recommendations.
• Prepare detailed captioned reports covering claim status, exposure, reserves, litigation strategy, and recommended resolution.
• Escalate matters exceeding assigned authority or requiring management involvement.
• Provide technical guidance to less experienced claims examiners as assigned, without formal supervisory responsibility.
• Follow established company procedures and client claims handling guidelines.

• Three or more years of related claims experience, or an equivalent combination of education and experience.
• Advanced knowledge of Texas workers’ compensation laws, regulations, and claims handling requirements.
• Demonstrated ability to independently manage highly complex, litigated, and high-exposure indemnity claims with minimal supervisory guidance.
• Strong analytical judgment and the ability to evaluate exposure and develop effective claims strategies.
• Experience directing defense counsel and evaluating litigation and resolution recommendations.
• Ability to prepare clear, detailed reports supporting claims decisions and recommendations.
• High school diploma or GED.
• Any license or certification required by applicable state regulations.

• Bachelor’s degree in a related field.

$80,000 to $85,000