Workers’ Compensation Claim Examiner Job at Robert Half (New Haven)

Claims Examiner - Workers Compensation

We are looking for a skilled Claims Examiner specializing in Workers Compensatio...

Location

United States , Alpharetta

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Active Adjuster’s license to handle Workers Compensation claims, or the ability to obtain one immediately upon starting employment
Minimum of three years of experience in Workers Compensation claim handling
Bachelor’s degree or equivalent relevant experience preferred
Proven ability to evaluate, analyze, and interpret complex information
Strong organizational skills and ability to manage multiple tasks effectively
Excellent verbal and written communication skills
Demonstrated critical thinking and decision-making abilities
Experience working collaboratively in team environments

Job Responsibility

Manage and investigate Workers Compensation claims, ensuring compliance with established procedures and regulations
Deliver outstanding customer service to insureds, claimants, agents, and other stakeholders through clear and effective communication
Accurately assess expenses and losses related to Lost Time claims, providing timely and detailed reports
Identify and address coverage issues, potential fraud, and subrogation opportunities while adhering to company guidelines
Develop and execute effective claim strategies to achieve early resolutions and positive outcomes
Maintain organized and up-to-date files using a diary system to monitor progress and follow up on new developments
Communicate trends, issues, and claim activities to internal and external customers in a timely manner
Collaborate with team members to ensure claims are managed and resolved effectively
Provide guidance and direction to colleagues to facilitate efficient claim processing and resolution

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Claims Examiner – Workers’ Compensation

This Workers’ Compensation Claims Examiner role requires an analytical, detail‑o...

Location

United States , Alpharetta

Salary:

30.00 - 31.00 USD / Hour

Robert Half

Expiration Date

Until further notice

Requirements

Must hold a valid adjuster's license to manage Workers Compensation claims or obtain one promptly after starting employment
A minimum of 3 years of experience handling Workers Compensation claims is required
Strong analytical skills with the ability to evaluate and interpret complex information effectively
Excellent organizational and time management skills, with the ability to handle multiple tasks simultaneously
Proven ability to work collaboratively in team settings and maintain positive working relationships
Exceptional verbal and written communication skills to convey information clearly and effectively
Bachelor's degree or equivalent detail-oriented experience is preferred
Commitment to delivering superior performance and customer satisfaction
Current Georgia Workers’ Compensation Adjuster License (required)
Additional licenses: Florida, South Carolina, North Carolina (strong plus)

Job Responsibility

Provide accurate and timely assessments of Workers’ Compensation Lost Time claims
Conduct thorough investigations, evaluate coverage, assess loss exposure, and manage cases according to established guidelines
Identify and appropriately address potential fraud, subrogation opportunities, and coverage concerns
Establish and execute effective case strategies to ensure timely and appropriate claim resolution
Deliver superior customer service to insureds, claimants, agents, underwriters, and internal partners
Communicate timely updates regarding claim activity, trends, and issue escalation
Maintain professional and effective interactions with all stakeholders
Ensure all claim files are up‑to‑date using a consistent diary system to monitor developments, follow‑ups, and required actions
Maintain accurate documentation aligned with regulatory requirements and internal quality standards
Achieve consistent compliance in investigation, coverage evaluation, loss assessment, and case management practices

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Fulltime

Workers Compensation Claims Examiner

The Workers Compensation Claims Examiner will be responsible for managing lost t...

Location

United States , Alpharetta

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Active Adjuster’s License for Workers Compensation in Georgia (required)
Minimum of 3 years of Workers Compensation claims handling experience
Strong analytical, organizational, and time management skills
Ability to multitask and prioritize effectively
Excellent verbal and written communication skills
Proven critical thinking and decision-making abilities
Ability to work collaboratively with diverse teams

Job Responsibility

Deliver superior customer service through effective interactions with insureds, claimants, agents, underwriters, and others
Collaborate with team members to achieve goals and maintain a high-performance environment
Provide accurate and timely expense and loss assessments on lost time claims
Communicate effectively with internal and external stakeholders regarding claim activity, trends, and issues
Conduct thorough investigations, coverage analysis, loss assessments, and case management
Develop and execute strategies to achieve early claim resolution
Identify and address coverage issues, potential fraud, and subrogation opportunities
Maintain organized and up-to-date claim files using a diary system
Monitor claim developments and follow up on outstanding items in a timely manner
Provide guidance and direction to team members when needed

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Fulltime

Sr. Customer Service Representative

We are looking for a detail-oriented individual to support workers’ compensation...

Location

United States , Atlanta

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience handling workers’ compensation claims with a strong understanding of claim lifecycle management and resolution practices
Knowledge of Georgia workers’ compensation rules, reporting obligations, and payment requirements
Ability to investigate claims, interpret documentation, and make sound decisions based on available facts
Skill in preparing clear written reports, recommendations, and claim-related correspondence
Proficiency in claims processing, claims data review, and use of claims management or claims edit systems
Strong communication skills for working effectively with employees, supervisors, medical providers, attorneys, and regulatory contacts
High attention to detail with the ability to maintain organized records and manage multiple deadlines in a fast-paced environment

Job Responsibility

Manage workers’ compensation cases from intake through resolution, applying Georgia regulations and established claim practices throughout the process
Examine claim details, incident information, and supporting documentation to determine appropriate next steps and claim direction
Produce clear written summaries, recommendations, and status updates that capture findings and support informed decision-making
Coordinate with injured employees, leaders, physicians, rehabilitation specialists, and state workers’ compensation contacts to facilitate recovery and return-to-work planning
Oversee the timely handling of medical and wage-related payments, while maintaining accurate files and submitting required state reporting within deadlines
Complete daily administrative activities such as opening new claims, reviewing incident materials, and updating claim records
Partner with legal counsel by supplying claim information, documentation, and case support for matters involving litigation
Identify recovery opportunities, including subrogation and applicable trust fund matters, and pursue them within required timeframes
Provide additional operational support as needed, including related assignments that assist broader departmental or field activities

What we offer

medical, vision, dental, and life and disability insurance
enrollment in company 401(k) plan

Fulltime

Payment Poster Specialist

We are looking for a Payment Poster Specialist to join an organization in Glen B...

Location

United States , Glen Burnie

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 2 years of experience in medical payment posting or a closely related healthcare reimbursement role
Hands-on experience working with Workers’ Compensation claims and payment processes
Familiarity with billing practices and reimbursement terminology
Ability to interpret explanation of benefits statements, remittance advice, and payer payment details
Knowledge of fee schedules and the ability to recognize underpayments, denials, and reimbursement discrepancies
Strong attention to detail with the ability to manage multiple accounts accurately in a fast-paced setting
Proficiency with healthcare billing systems and standard payment posting workflows

Job Responsibility

Record and apply insurance and patient payments accurately to the appropriate accounts within established timelines
Review explanation of benefits documents and remittance details to confirm payment accuracy and identify issues requiring follow-up
Reconcile posted transactions against account balances to ensure reimbursement records are complete and correct
Examine Workers’ Compensation payments against applicable fee schedules to detect variances, underpayments, or denials
Escalate reimbursement discrepancies and unresolved claim issues to the appropriate team members for further action
Maintain thorough and organized documentation of posting activity, account adjustments, and payment-related exceptions
Support high-volume payment workflows while preserving accuracy, consistency, and compliance with billing standards

What we offer

Medical
Vision
Dental
Life insurance
Disability insurance
401(k) plan
Free online training

Fulltime

Claims Assistant

We are looking for a detail-oriented Claims Assistant to support claims operatio...

Location

United States , Reno

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

3+ years of experience in claims support, administrative assistance, or a related office-based role
Hands-on knowledge of workers' compensation claims processing and benefit administration
Ability to perform accurate data entry and maintain detailed documentation in a fast-paced environment
Experience handling inbound calls and providing attentive customer support to a variety of stakeholders
Working understanding of basic medical terminology relevant to injury-related claims
Strong organizational skills with the ability to prioritize multiple tasks and follow deadlines
Clear written and verbal communication skills for interacting with internal teams and external contacts

Job Responsibility

Review claim information, assess supporting details, and help establish appropriate reserves based on injury information, expected costs, and claim circumstances
Deliver attentive service to internal teams, claimants, employers, medical providers, and other partners through consistent and timely communication
Process benefits accurately in alignment with applicable regulations and company standards, including preparation and submission of required state documentation
Coordinate medical treatment activity and track claim progress to help keep files moving efficiently toward resolution
Use available internal and external resources to support cost control efforts and reduce claim exposure where appropriate
Examine claim files for potential legal concerns, work with attorneys as needed, and support settlement evaluation within established authority levels
Maintain organized claim records through careful data entry, documentation review, and ongoing administrative support
Manage inbound calls and respond to routine inquiries related to claim status, required forms, and next steps
Conduct regular reviews of assigned files to identify updates, outstanding items, and opportunities to advance claim handling

What we offer

Medical, vision, dental, and life and disability insurance
401(k) plan

Claims Technician

We are looking for a detail-oriented Claims Technician to provide administrative...

Location

United States , Pleasant Hill

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 1 year of office support or clerical experience involving data entry, document handling, and work management in a fast-paced setting
High school diploma or equivalent education
Familiarity with administrative support practices, recordkeeping, and general office procedures
Ability to work accurately within online systems and business software used for claim documentation and correspondence
Strong written and verbal communication skills with the ability to interact professionally with internal teams and external parties
Working knowledge of basic math, document preparation, filing, and office equipment operation
Ability to prioritize multiple assignments, follow instructions carefully, and meet time-sensitive deadlines
Experience supporting workers’ compensation processes, medical records handling, or claims-related administrative work is preferred

Job Responsibility

Provide day-to-day administrative support for workers’ compensation files, ensuring records, forms, and documentation are maintained accurately and efficiently
Create and update correspondence and claim-related documents using claims management platforms and standard office applications
Examine, authorize, and process invoices tied to claim activity, including medical review services, nursing support, mileage reimbursements, and legal billing
Compile and send medical reports and supporting materials within required deadlines, confirming each submission is complete and accurate before release
Distribute medical records and related documentation to attorneys and other authorized parties in a timely manner
Perform data entry and file maintenance to support organized claim handling and dependable recordkeeping
Use common office equipment such as computers, copiers, and fax machines to prepare, reproduce, and assemble claim materials
Assist broader claims operations with administrative tasks, special assignments, and other support needs as directed by leadership

What we offer

Medical insurance
Vision insurance
Dental insurance
Life insurance
Disability insurance
401(k) plan

Fulltime

Claims Assistant

Robert Half's client in Walnut Creek, CA is seeking a Claims Assistant for a lon...

Location

United States , Pleasant Hill

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Interest in claims, healthcare administration, or insurance operations
Comfort working with detailed records, forms, and data
Strong organization, follow-through, and attention to detail
Clear, professional communication skills
Ability to manage multiple tasks and deadlines
Willingness to learn Workers’ Compensation regulations and internal best practices
Proficiency with office software and standard office tools
Experience providing administrative support in a claims, insurance, medical, or similar office environment
Working knowledge of workers’ compensation processes, insurance claims handling, or medical claims documentation
Familiarity with medical terminology and the ability to interpret reports and supporting records accurately

Job Responsibility

Support the processing of Workers’ Compensation claims, with a focus on medical-only and indemnity claims
Keep claims moving by tracking documentation, reviewing medical reports, and ensuring accuracy and compliance
Prepare benefit payments, authorizations, and invoices
Communicate with claimants, school districts, medical providers, and partner agencies
Calculate benefits, enter and maintain claim data, and manage claim files
Schedule medical evaluations and coordinate provider follow-ups
Track employee work status and support return-to-work efforts
Assist Claims Examiners and contribute to special projects as needed

What we offer

Medical, vision, dental, and life and disability insurance
Eligibility to enroll in company 401(k) plan

Fulltime

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