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Claims Examiner - Workers Compensation

Epitec Inc
  • Detroit, MI
    17 days ago

    Job Description

    Claims Examiner - Workers Compensation - Epitec Skip to content

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    Claims Examiner - Workers Compensation

    By / June 4, 2026

    • Type: Contract
    • Job #103984

    Title

    Claims Examiner - Workers' Compensation

    Location

    Brea, California

    Schedule

    Monday - Friday, standard business hours

    Type

    Full-time, Ongoing W2 Contract, New Role & Possible Extensions

    Pay Rate

    $45.50, with overtime pay

    Benefits

    Medical, Dental, Vision, 401(k), Life Insurance, Disability Coverage, 1 Week of Paid Sick Leave, No PTO but able to take off

    Summary

    Our client is seeking a Claims Examiner - Workers' Compensation to manage complex and high-exposure claims, including those involving litigation and rehabilitation. This role is responsible for analyzing claims, determining benefits, and ensuring timely and accurate adjudication in alignment with industry standards and client-specific requirements.

    This position is ideal for a claims professional with strong experience in workers' compensation, claim investigation, and settlement negotiation who can manage claims independently while maintaining compliance and cost effectiveness.

    The Claims Examiner will work closely with claimants, clients, legal teams, and vendors to drive timely resolution and maintain high-quality claim file documentation.

    Key Responsibilities

    Claims Investigation & Management

    • Analyze and process complex or technically difficult workers' compensation claims
    • Investigate claims to determine exposure and establish appropriate action plans
    • Manage claims through resolution in a timely and compliant manner

    Settlement & Financial Management

    • Negotiate settlements within designated authority level
    • Calculate and assign claim reserves; manage reserve adequacy throughout the claim lifecycle
    • Calculate and issue benefit payments, adjustments, and settlements

    Litigation & Compliance

    • Manage the litigation process and coordinate with legal teams
    • Prepare and submit required state filings within statutory deadlines
    • Ensure claim handling aligns with industry best practices and client requirements

    Vendor & Cost Management

    • Coordinate vendor referrals for investigation and litigation support
    • Utilize cost containment strategies and vendor partnerships to control claim expenses

    Recovery & Reporting

    • Manage claim recoveries including subrogation, Second Injury Fund, and offsets (Social Security/Medicare)
    • Report claims to excess carriers and respond to requests in a timely and professional manner

    Communication & Documentation

    • Communicate claim updates with claimants and clients
    • Maintain strong client relationships through professional communication
    • Ensure claim files are accurately documented and coded

    Required Education & Experience

    • Bachelor's degree from an accredited college or university preferred
    • Experience handling workers' compensation claims, including complex or litigated cases

    Required Skills & Qualifications

    • Strong knowledge of workers' compensation claims handling
    • Experience investigating and analyzing claim exposure
    • Experience negotiating settlements within authority limits
    • Ability to calculate reserves and manage financial aspects of claims
    • Understanding of litigation management and compliance requirements
    • Strong documentation and organizational skills
    • Ability to manage multiple claims in a fast-paced environment
    • Strong written and verbal communication skills

    Preferred Skills & Qualifications

    • Professional certification related to workers' compensation or claims (preferred)
    • Experience with high-exposure or litigated claims
    • Familiarity with subrogation and recovery processes

    #LI-JH1

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    Numbers & Facts

    LocationDetroit, MI
    IndustryStaffing/Employment Agencies
    Company Size2,500 to 4,999 employees
    Year Founded1978
    Websitehttps://epitec.com/

    Benefits

    Professional Development, 401K, Employee Referral Program, Life Insurance

    About Company

    Epitec is a leading staffing and recruiting services company with a mission to make staffing personal. We go beyond traditional hiring by truly understanding our candidates and matching them with the perfect opportunities. We offer competitive compensation, career growth, and support throughout the entire process. Working with top Fortune 500 companies, we are recognized for our excellence with numerous awards, including Best & Brightest and diversity recognitions. At Epitec, we're redefining the future of employment. 

    Skills

    • Adjudicationunmatched
    • Alliance/Partner Managementunmatched
    • Best Practicesunmatched
    • Claims Managementunmatched
    • Claims Processingunmatched
    • Communication Skillsunmatched
    • Cost Controlunmatched
    • Cost Effectiveness Analysisunmatched
    • Customer Relationsunmatched
    • Develop and Maintain Customersunmatched
    • Documentationunmatched
    • Financial Managementunmatched
    • Industry Standardsunmatched
    • Legalunmatched
    • Legal Support Skillsunmatched
    • Litigationunmatched
    • Maintain Complianceunmatched
    • Medicareunmatched
    • Negotiation Skillsunmatched
    • Presentation/Verbal Skillsunmatched
    • Process Analysisunmatched
    • Process Managementunmatched
    • Quality Managementunmatched
    • Regulatory Complianceunmatched
    • Statement of Work (SOW)unmatched
    • Subrogationunmatched
    • Time Managementunmatched
    • Vendor/Supplier Planningunmatched
    • Worker's Compensationunmatched
    • Writing Skillsunmatched

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