Sr Claim Examiner- WC

Job Title: 

Sr. Claim Examiner – Workers' Compensation 

Location: 

Fairfax, Virginia 

Job Type: 

Full-time, 2-month On-Going Contract, W2 

Schedule: 

Monday – Friday, Remote, EST preferred  

Pay Range: 

$35.59 per hour  

Visa sponsorship is not available now or in the near future. 

Job Description:  

Key Responsibilities: 

• Interpret policy coverages and determine claim applicability. 

• Manage complex workers' compensation claims throughout the claim lifecycle. 

• Conduct and oversee claim investigations. 

• Direct litigation and discovery strategy in partnership with legal counsel. 

• Establish appropriate reserves and authorize claim payments within authority limits. 

• Negotiate and settle claims promptly and equitably. 

• Ensure timely issuance of payments and claim disbursements. 

• Identify and pursue subrogation and third-party recovery opportunities. 

• Analyze claims activity and prepare reports for clients, carriers, and management. 

• Participate in claim reviews and provide recommendations on claim strategy. 

Requirements 

• 4+ years of workers' compensation claims experience. 

• Experience handling complex and litigated workers' compensation claims. 

• Strong reserve analysis and settlement authority experience. 

• Experience with claim investigations and recovery efforts. 

• Active Workers' Compensation Adjuster License as required by jurisdiction. 

• Ability to work effectively in a remote environment. 

Preferred Qualifications 

• Experience with subrogation and third-party recovery. 

• Prior experience with carriers, TPAs, or self-insured organizations. 

• Multi-state workers' compensation claim handling experience. 

• Professional insurance industry designations. 

Skills 

• Strong workers' compensation claims management expertise. 

• Advanced investigative and claim resolution skills. 

• Excellent written and verbal communication skills. 

• Strong negotiation and presentation abilities. 

• Ability to work independently and make sound business decisions. 

• Advanced analytical and problem-solving capabilities. 

• Ability to prioritize and manage multiple claims simultaneously. 

• Experience collaborating with legal counsel on litigated claims. 

Education 

• Bachelor's degree or equivalent experience required. 

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