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Workers’ Compensation Claim Examiner

https://www.roberthalf.com Logo

Robert Half

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Location:
United States , New Haven

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Category:
Insurance

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Contract Type:
Not provided

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Salary:

Not provided
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Job Responsibility:

  • Handle all aspects of workers’ compensation claims from inception to closure while maintaining strong customer relations
  • Review claim and policy information to establish investigative background
  • Conduct ongoing three‑part investigations, including fact‑finding and statement collection from insureds, claimants, and medical providers
  • Evaluate investigation findings to determine claim compensability
  • Notify insureds, claimants, and attorneys of claim denials when applicable
  • Prepare investigative reports, settlements, denials, and evaluations of involved parties
  • Administer statutory medical and/or indemnity benefits accurately and timely throughout the life of the claim
  • Set medical, indemnity, and expense reserves within authority limits and recommend reserve changes to the Team Leader as needed
  • Perform regular claim reviews and recommend corrective or remedial actions to address issues
  • Identify and escalate unusual or potentially adverse exposures to leadership

Requirements:

  • 3+ years of Workers’ Compensation Claim Examiner experience or commensurate transferable experience
  • Direct workers’ compensation experience is preferred but not required, provided transferable claims skills are present
  • Experience working in a fast‑paced, customer‑focused environment
  • Strong verbal, written, and telephonic communication skills
  • Prior roles requiring high levels of organization, follow‑up, and accountability
  • Proficiency with Microsoft Office products
  • Claim Adjuster licenses in Connecticut, New Hampshire, Rhode Island, and Vermont are required but not necessary at the time of posting
  • If not currently licensed, the selected candidate will be required to obtain an applicable resident or designated home‑state adjuster license and any required additional state licenses

Nice to have:

  • Familiarity with healthcare claims, disability claims, auto/PIP, medical injury, general liability, or medical billing is a plus
  • Prior insurance, legal, or corporate business experience is a plus
  • AIC, RMA, or CPCU coursework or designations are a plus
  • Knowledge of medical terminology and bill processing is a plus
What we offer:
  • medical, vision, dental, and life and disability insurance
  • eligible to enroll in our company 401(k) plan

Additional Information:

Job Posted:
April 11, 2026

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