Texas Claims Examiner Workers Compensation

Claims Examiner – Texas Workers’ Compensation

Job Type: Full-Time
Location: Remote/Texas/Hybrid Ideal

Pay range: $70,000 to $90,000 Depending on experience

Position Summary

We are seeking a Workers’ Compensation Claims Examiner to manage indemnity claims of moderate to complex severity from initial assignment through resolution. This position requires independent judgment, knowledge of workers’ compensation regulations, and the ability to manage claims within established authority limits and client guidelines. The examiner will identify potential exposure concerns, coordinate litigation activities, and consult with management on complex or sensitive claims.

Key Responsibilities

• Manage a caseload of approximately 150 workers’ compensation indemnity claims of moderate to complex difficulty.

• Establish and maintain appropriate claim reserves.

• Authorize benefit payments and settlements within assigned authority limits.

• Identify and escalate claims involving significant exposure, complex compensability issues, sensitive client concerns, or matters requiring additional authority.

• Refer claims to defense counsel when appropriate and monitor litigation throughout the claims process.

• Collaborate with supervisors regarding significant legal developments, settlement strategies, and claims requiring additional oversight.

• Ensure claims are handled in accordance with applicable state regulations, client requirements, and established procedures.

• Maintain accurate claim documentation and communicate effectively with claimants, clients, attorneys, and other stakeholders.

Qualifications

• Three to five years of related claims handling experience, involving workers’ compensation indemnity claims.

• Bachelor’s degree in a related field preferred, or an equivalent combination of education and experience.

• Knowledge of workers’ compensation regulations, statutory requirements, and medical terminology.

• Ability to independently manage complex claims and exercise sound judgment within established authority limits.

• Strong analytical, organizational, written, and verbal communication skills.

• Ability to communicate technical claims information effectively to claimants, clients, and internal teams.

• Proficiency in Microsoft Word and Excel preferred.

• Required licenses or certifications in accordance with applicable state regulations.

Working Conditions:

· May on occasion be exposed to loud sounds and distracting noise levels, such as from office equipment.

· The ability to lift up to 30lbs

· Use of computers and technology

Here at Canon Recruiting, People are our priority, and we are committed to Include Diversity in every segment of who we are. It is only through our Diversity, we are made a stronger organization, and increase our ability to provide top tier candidates that our clients have come to know Canon for. We have an inclusive environment all employees are celebrated for their unique differences. The different perspectives and experiences of our workforce give us the competitive advantage that is essential for success in an ever-changing market. By promoting inclusion with the same enthusiasm, we devote to quality and competency, and using the experience from a diverse assortment of backgrounds and experiences, Canon is able to improve the services and value we deliver to clients, employees, and customers. At Canon, Diversification and Inclusiveness are much more than a corporate ambition; they are a critical component in our daily corporate life.

Canon Recruiting is committed to a diverse and inclusive workplace. Canon Recruiting is an equal opportunity employer and does not discriminate on the basis of race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.

The pay range for this position is listed above. Base pay information is based on market location. We will consider for employment qualified applicants with arrest and conviction records. Our range of benefits may include health care and 401(k) savings plans. For individuals with disabilities who would like to request an accommodation, please email [email protected]