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Senior Claims Examiner Jobs (NOW HIRING)

Athens Administrators

Senior Claims Examiner

Orange, CA · On-site +1

$50.29 - $55.87/hr

Senior Claims Examiner Department: Workers' Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead ...

Athens Administrators

Senior Claims Examiner

San Diego, CA · On-site +1

$50.29 - $55.87/hr

Senior Claims Examiner Department: Workers' Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead ...

Markel International

Senior Claims Examiner

Rosemont, IL · Hybrid

$33 - $44.75/hr

The national average salary for the Sr. Claims Examiner is $78,000 - $107,250 with 15% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20 ...

Markel International

Senior Claims Examiner

Chicago, IL · Hybrid

$33.75 - $45.75/hr

The national average salary for the Sr. Claims Examiner is $78,000 - $107,250 with 15% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20 ...

Markel International

Senior Claims Examiner

Omaha, NE · Hybrid

$31.25 - $42.50/hr

The national average salary for the Sr. Claims Examiner is $78,000 - $107,250 with 15% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20 ...

Hiscox

Sr. Claims Examiner

Boston, MA · On-site

$80K - $125K/yr

The Senior Claims Examiner adjudicates assigned claims within given authority and provides operational support to the claims team. This person also: * Adjusts and resolves moderate to complex claims ...

Markel International

Senior Claims Examiner

Alpharetta, GA · Hybrid

$32 - $43.50/hr

The national average salary for the Sr. Claims Examiner is $78,000 - $107,250 with 15% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20 ...

Markel

Senior Claims Examiner

Summit, NJ · Hybrid

$34.75 - $47.25/hr

The national average salary for the Sr. Claims Examiner is $78,000 - $107,250 with 15% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20 ...

Markel International

Senior Claims Examiner

Plano, TX · Hybrid

$31.25 - $42.50/hr

The national average salary for the Sr. Claims Examiner is $78,000 - $107,250 with 15% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20 ...

Markel International

Senior Claims Examiner

Summit, NJ · Hybrid

$34.75 - $47.25/hr

The national average salary for the Sr. Claims Examiner is $78,000 - $107,250 with 15% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20 ...

Markel Corporation

Senior Claims Examiner

Richmond, VA · On-site

$32.50 - $44/hr

The national average salary for the Sr. Claims Examiner is $78,000 - $107,250 with 15% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20 ...

Markel International

Senior Claims Examiner

Red Bank, NJ · Hybrid

$33.50 - $45.75/hr

The national average salary for the Sr. Claims Examiner is $78,000 - $107,250 with 15% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20 ...

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Senior Claims Examiner information

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$37K

$86.2K

$128.5K

How much do senior claims examiner jobs pay per year?

As of Aug 8, 2026, the average yearly pay for senior claims examiner in the United States is $86,162.00, according to ZipRecruiter salary data. Most workers in this role earn between $66,000.00 and $104,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a senior claims examiner, and why are they important?

To thrive as a Senior Claims Examiner, you need strong analytical skills, in-depth knowledge of insurance policies, and significant experience in claims processing, usually supported by a relevant degree or professional certification. Familiarity with claims management systems, regulatory compliance tools, and advanced Excel functions is typically required. Exceptional attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These skills are essential for ensuring accurate claims assessment, minimizing risk, and maintaining regulatory compliance within the organization.

What is the difference between Senior Claims Examiner vs Claims Adjuster?

AspectSenior Claims ExaminerClaims Adjuster
Required CredentialsClaims licensing, insurance certifications, experience in claims processingInsurance licenses, certifications vary by state, claims handling experience
Work EnvironmentInsurance companies, government agencies, claims departmentsInsurance companies, third-party administrators, independent agencies
Employer & Industry UsageCommonly employed in insurance firms and government programsWidely used across insurance sectors, including auto, health, and property claims

While both roles involve handling insurance claims, Senior Claims Examiners typically focus on reviewing complex claims and ensuring compliance, often working within insurance companies or government agencies. Claims Adjusters generally handle a broader range of claims, including initial assessments and settlements, and may work independently or for third-party firms. The roles overlap in credentials and work environment but differ in scope and responsibilities.

What are some common challenges faced by senior claims examiners, and how can they be addressed?

Senior Claims Examiners often face challenges such as handling complex or high-value claims, staying updated on evolving regulations, and managing a high volume of detailed casework. To address these, it's important to maintain strong organizational skills, leverage technology for efficiency, and participate in ongoing training. Collaboration with legal teams, underwriters, and other examiners is also key to resolving difficult cases and ensuring accurate claim assessments.

What does a senior claims examiner do?

A Senior Claims Examiner is responsible for reviewing, analyzing, and processing complex insurance claims to determine their validity and ensure compliance with policy terms. They handle escalated or high-value claims, investigate details, evaluate evidence, and communicate with policyholders, medical professionals, or legal teams as necessary. Senior Claims Examiners also mentor junior staff, recommend claim settlements, and contribute to improving claims processing procedures. Their expertise helps minimize company risk and maintain customer satisfaction.
More about Senior Claims Examiner jobs
What cities are hiring for Senior Claims Examiner jobs? Cities with the most Senior Claims Examiner job openings:
What are the most commonly searched types of Claims Examiner jobs? The most popular types of Claims Examiner jobs are:
Who are the top companies hiring for Senior Claims Examiner jobs? The top employers for Senior Claims Examiner jobs are:
What states have the most Senior Claims Examiner jobs? States with the most job openings for Senior Claims Examiner jobs include:
What job categories do people searching Senior Claims Examiner jobs look for? The top searched job categories for Senior Claims Examiner jobs are:
Senior Claims Examiner jobs near you
Infographic showing various Senior Claims Examiner job openings in the United States as of August 2026, with employment types broken down into 91% Full Time, 7% Part Time, and 2% Contract. Highlights an 85% Physical, 4% Hybrid, and 11% Remote job distribution, with an average salary of $86,162 per year, or $41.4 per hour.

Senior Claims Examiner - 4850

Athens Administrators

Orange, CA • On-site, Remote

$50.29 - $55.87/hr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 28 days ago

Job description

ATHENS POSITION DETAILS
Position Title:
Senior Claims Examiner
Department:
Workers’ Compensation California
Reports To:
Claims Supervisor
FLSA Status:
Non-Exempt
Job Grade:
12
Career Ladder:
Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor
ATHENS ADMINISTRATORS
Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property amp; Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!
POSITION SUMMARY
Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation offices and can be located in Southern California. Employees who live less than 26 miles from the Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule.
The Senior Claims Examiner will adjust police and fire 4850 workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. The Senior Claims Examiner will adjust workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. Experience in 4850 claims is required.
PRIMARY RESPONSIBILITIES
Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
  • Establish contact with employer to review issues
  • Respond to inquiries from the employer, employee, doctors, and attorneys
  • Establish and maintain appropriate reserves
  • Review legal correspondence and medical reports
  • Evaluate and approve medical procedures and treatment
  • Administer benefits and ensure appropriateness of all payments
  • Investigate coverage, liability, and monetary value of claim
  • Review medical and legal bills for appropriateness
  • Discuss appropriateness of medical treatment with medical case manager
  • Determine compensability
  • Monitor and assist litigation
  • Negotiate settlement of claim, liens, rehabilitation plans, etc.
  • Prepare and present reports to clients
  • Appropriately close claims
  • Help resolve client billing and payment inquiries
  • Investigate complaints from injured workers
  • Document and code the claim files and claims system with all relevant information
  • Maintain and update action plans within specified time frames
  • Provide direction to Claims Assistants and Claims Technicians and assist with training, coaching, and mentoring as needed for them to support daily claims tasks
  • Contact with employers, employees, attorneys, doctors, vendors, and other parties
  • Provide customer service and support to clients and claimants
  • Work collaboratively with attorneys to draft settlements and assist with litigation strategies
  • Negotiate settlements
  • Authorize and negotiate cost of medical treatment and supplies
  • Internal communication with staff
  • Prepare professional, well written correspondence and other communications
ESSENTIAL POSITION REQUIREMENTS
The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
  • High School Diploma or equivalent (GED) required for all positions
    • AA/AS or BA/BS preferred but not required
  • Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained
  • Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f)
  • 3+ years recent workers compensation claims handling experience required
  • 4850 claims experience required
  • At least 5 years of workers compensation claims experience preferred
  • Solid knowledge of workers compensation laws, policies, and procedures’
  • Completion of IEA or equivalent courses
  • Proficiency in determining case value and negotiating settlements
  • Understanding of medical and legal terminology
  • Mathematical calculating skills
  • Well-developed verbal and written communication skills with strong attention to detail
  • Excellent organizational skills and ability to multi-task
  • Ability to type quickly, accurately and for prolonged periods
  • Proficient in Microsoft Office Suite
    • Ability to learn additional computer programs
  • Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
  • Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
  • Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
  • Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
  • Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor.
  • Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
  • Must be able to reliably commute to meetings and events as required by this position
APPLY WITH US
We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at http://www.athensadmin.com/careers/job-openings Feel free to include a cover letter if you’d like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: https://dcba.lacounty.gov/wp-content/uploads/2024/08/FCOE-Official-Notice-Eng-Final-8.30.2024.pdf
This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training.
Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
THANK YOU!
We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don’t forget to check out our website at www.athensadmin.com as well as our LinkedIn, Glassdoor, and Facebook pages!
Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses amp; certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD amp;D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA amp; FSA options, 401k (and Roth), Company-Paid STD amp; LTD and more! Further information about our comprehensive benefits package may be found on our website at https://www.athensadmin.com/careers/why-work-here

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