Workers Compensation Claims Examiner III _; Temp

Job Details

Level: Experienced
•

Location:

Houston Office - Houston, TX 77040
• Position Type:
Full Time
• Education Level: High School Diploma or GED
• Salary Range: $73,000.00 - $88,000.00
• Travel:
None
• Shift: Day
• Job Category:
Admin - Clerical

Hybrid position for employees residing in Houston, TX; remote work possible for those outside Houston with occasional in‑person meetings.

Under minimal supervision, manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines.

• Effectively manages a caseload of 110 to 150 workers’ compensation files, including very complex claims.
• Initiates and conducts investigations in a timely manner.
• Determines compensability of claims and administers benefits based on state law and company guidelines.
• Manages medical treatment and billing, authorizing as appropriate.
• Communicates with claimants, providers, and vendors regarding claim issues.
• Computes reserves within company guidelines.
• Maintains diary system for case review and documents file status.
• Provides timely information to clients to resolve claims efficiently, including trends or safety concerns.
• Adheres to all company policies and procedures.
• Conducts file reviews independently.
• Other duties as assigned.

• Education/
  
  Experience:
  
  High School Diploma or GED required. Bachelor’s degree in related field preferred; five (5) or more years of related experience, or equivalent combination of education and experience.
• Knowledge, Skills, and Abilities:
  • Technical knowledge of statutory regulations and medical terminology.
  • Analytical skills.
  • Excellent written and verbal communication abilities, including conveying technical details.
  • Effective interaction with persons at all levels.
  • Independent and effective management of complex claims.
  • Proficiency in Word and Excel preferred.
• Other
  
  Qualifications:
  
  Texas Workers Compensation License.

Candidate must be able to perform tasks requiring sustained mental focus and physical effort, including:

• Lifting, carrying, or moving objects up to 20 pounds.
• Standing, walking, and performing repetitive finger movements.
• Reading, writing, and operating office equipment.
• Responding to voice and written communication accurately.

• Computer, 10‑key, fax machine, copier, printer, and other office equipment.

• Appropriate office attire.