Claims Examiner - Workers Compensation (Hourly)

Mindlance

Brea, CA(remote)

Apply

JOB DETAILS

SALARY

$47–$48 Per Hour

SKILLS

Adjudication, Alliance/Partner Management, Analysis Skills, Best Practices, Claims Coding, Claims Management, Claims Processing, Cost Control, Customer Relations, Customer Support/Service, Data Collection, Develop and Maintain Customers, Litigation, Medicare, Negotiation Skills, Patents, Process Analysis, Process Management, State Laws and Regulations, Subrogation, Time Management, Vendor/Supplier Planning, Worker's Compensation

LOCATION

Brea, CA(remote)

POSTED

11 days ago

Reason: Vacant Position
Department: Brea, CA
Job Category: Claims Services
Job Title: Claims Examiner - Workers Compensation (Hourly)
Duties: PRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
Skills: ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

Negotiates settlement of claims within designated authority.

Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.

Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.

Prepares necessary state fillings within statutory limits.

Manages the litigation process; ensures timely and cost effective claims resolution.

Coordinates vendor referrals for additional investigation and/or litigation management.

Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.

Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.

Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.

Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.

Ensures claim files are properly documented and claims coding is correct.

Refers cases as appropriate to supervisor and management.

Keywords:
Education: Education & Licensing
Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
Skills and Experience:
Patents: No
Publications: No
Veteran Status: No
# of Positions: 1

Location:
Brea, CA
3230 East Imperial Hwy,

Schedule:
Start Date: 06/16/2026
Estimated End Date: 09/30/2026
Hours Per Week: 37.50
Hours Per Day: 7.50
Interview Notes: 7.5 hours x 5 days = 37.5 hours/week
Financials:

Currency USD

Contact Information:
MSP Contact Name:
MSP Phone:

About the Company

Mindlance

Resume Resources

Free Resume Templates Free Resume Builder