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Claims Examiner Workers Compensation Jobs (NOW HIRING)

Sedgwick

Claims Examiner - Workers Compensation

Roseville, CA · On-site

$34.25 - $46.75/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... Claims Examiner - Workers Compensation | Roseville, CA Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the ...

Sedgwick

Claims Examiner - Workers Compensation

Roseville, CA · Remote

$80/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... Claims Examiner - Workers Compensation | Roseville, CA Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the ...

Gallagher

Claims Examiner, Workers' Compensation

Rancho Cordova, CA · Remote

$35 - $47.50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Specializing in employee benefits, workers' compensation, loss control, financial services, and ... As a Claims Examiner, you'll take ownership of indemnity claims, ensuring timely and accurate ...

TEEMA

Workers Compensation Claims Examiner

Houston, TX · On-site

$36 - $41/hr

Senior Workers' Compensation Claims Examiner (Texas Licensed ) We are seeking an experienced Workers' Compensation Claims Examiner to join a collaborative claims team handling complex indemnity ...

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Claims Examiner Workers Compensation information

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$15

$36

$46

How much do claims examiner workers compensation jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for claims examiner workers compensation in the United States is $36.99, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $42.79 per hour, depending on experience, location, and employer.

What is a claims examiner workers compensation?

Claims Examiner Workers Compensation are professionals who review and process workers' compensation claims to ensure they comply with laws and policies. They investigate the details of workplace injuries or illnesses, evaluate medical reports, and determine whether claims are valid and how much compensation should be paid. Their work involves communicating with employers, employees, healthcare providers, and sometimes legal representatives. The goal is to ensure fair and timely resolution of workers' compensation claims while preventing fraud.

How does a claims examiner workers compensation collaborate with medical professionals and employers during the claims process?

Claims Examiners for Workers Compensation frequently interact with medical providers to obtain and review medical records, clarify treatment plans, and assess the extent of an employee’s injuries. They also communicate with employers to gather incident details and confirm employment information. Effective collaboration ensures accurate claim evaluation, timely benefits delivery, and compliance with legal requirements. Building solid professional relationships with these stakeholders is key to managing complex or disputed claims successfully.

What are the key skills and qualifications needed to thrive as a claims examiner workers compensation?

To thrive as a Claims Examiner Workers Compensation, you need a thorough understanding of insurance policies, workers' compensation laws, and claims investigation, often backed by a relevant degree or experience in insurance or claims handling. Familiarity with claims management software, medical terminology, and certification such as Associate in Claims (AIC) is typically required. Attention to detail, strong analytical skills, and effective communication are standout soft skills for this role. These competencies ensure accurate claim assessments, compliance with regulations, and fair resolutions for all parties involved.

What is the difference between Claims Examiner Workers Compensation vs Claims Adjuster?

AspectClaims Examiner Workers CompensationClaims Adjuster
CredentialsHigh school diploma or equivalent; some roles may require licensing or certificationsHigh school diploma or equivalent; licensing often required
Work EnvironmentOffice setting, handling workers' compensation claimsOffice or field, handling various insurance claims
Industry UsagePrimarily in workers' compensation insuranceIn multiple insurance sectors including auto, health, and property
Job FocusReviewing and processing workers' compensation claimsInvestigating and settling various insurance claims

While both roles involve reviewing insurance claims, Claims Examiner Workers Compensation specializes in processing workers' compensation cases, often requiring specific knowledge of workers' injury laws. Claims Adjusters handle a broader range of insurance claims across different sectors, with a focus on investigation and settlement. Understanding these differences helps job seekers identify the right career path within the insurance industry.

More about Claims Examiner Workers Compensation jobs

What cities are hiring for Claims Examiner Workers Compensation jobs?

Cities with the most Claims Examiner Workers Compensation job openings:

What states have the most Claims Examiner Workers Compensation jobs?

States with the most job openings for Claims Examiner Workers Compensation jobs include:

What job categories do people searching Claims Examiner Workers Compensation jobs look for?

The top searched job categories for Claims Examiner Workers Compensation jobs are:

Claims Examiner Workers Compensation jobs near you
Infographic showing various Claims Examiner Workers Compensation job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, and 4% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $76,935 per year, or $37 per hour.

Claims Examiner - Workers Compensation

Vytwo

Prosper, TX • On-site

$35/hr

Full-time

Re-posted 11 days ago

Job description

Title: Claims Examiner - Workers Compensation (1431041)
Location: Remote
Duration: 03+ Months
Manager's notes:
Mandatory: Work comp claims handling experience is needed; loss time.
Minimum 3+years of relevant WC experience required.
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.
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. 

Education & Licensing
Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
Experience
Five (5) years of claims management experience or equivalent combination of education and experience required. 
Skills & Knowledge 
Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations