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Worker Compensation Claims Examiner Jobs (NOW HIRING)

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 ...

Acrisure

Workers Compensation Claims Examiner

Atlanta, GA · On-site

$31.50 - $42.75/hr

Acrisure is seeking a Workers' Compensation Claims Examiner. This role is responsible for managing lost time workers' compensation claims from assignment through resolution while ensuring timely ...

Acrisure

Workers Compensation Claims Examiner

Atlanta, GA · On-site

$31.50 - $42.75/hr

Acrisure is seeking a Workers' Compensation Claims Examiner. This role is responsible for managing lost time workers' compensation claims from assignment through resolution while ensuring timely ...

Sedgwick

Workers Compensation Claims Examiner

San Diego, CA · Hybrid

$80K - $100K/yr

... Workers Compensation Claims Examiner 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 world's best brands?

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

As of Aug 8, 2026, the average hourly pay for worker compensation claims examiner 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 are the key skills and qualifications needed to thrive as a worker compensation claims examiner?

To thrive as a Worker Compensation Claims Examiner, you need strong analytical skills, attention to detail, and a solid understanding of state and federal workers' compensation laws, often supported by a degree in business, insurance, or a related field. Familiarity with claims management software such as Risk Management Information Systems (RMIS) and, in some states, relevant certifications like the Associate in Claims (AIC) are typically required. Excellent communication, negotiation, and customer service skills help you interact effectively with claimants, medical providers, and employers. These competencies are vital for ensuring fair, timely, and compliant claims processing, minimizing risk for employers, and supporting injured workers efficiently.

What is a worker compensation claims examiner?

Worker Compensation Claims Examiners are professionals who review, investigate, and process claims filed by employees who are injured or become ill due to their job. They evaluate the validity of each claim, verify documentation, and determine the extent of the employer’s liability for medical costs and lost wages. Claims Examiners also communicate with medical providers, employers, and claimants to ensure all information is accurate and up to date. Their goal is to ensure that claims are handled fairly and in accordance with state and federal regulations.

What are some common challenges worker compensation claims examiners face when handling complex cases?

Worker Compensation Claims Examiners often encounter challenges such as investigating conflicting medical reports, coordinating with multiple parties (including employers, medical providers, and attorneys), and staying current with frequently changing regulations. Managing a high caseload while ensuring timely and accurate claims decisions can also be demanding. Successful examiners develop strong organizational and communication skills to efficiently manage these complexities and resolve cases fairly.
More about Worker Compensation Claims Examiner jobs
What states have the most Worker Compensation Claims Examiner jobs? States with the most job openings for Worker Compensation Claims Examiner jobs include:
What job categories do people searching Worker Compensation Claims Examiner jobs look for? The top searched job categories for Worker Compensation Claims Examiner jobs are:
Worker Compensation Claims Examiner jobs near you

Worker's Compensation Claims Examiner

FutureRecruit

Spring Valley, NY

$33.25 - $45/hr

Full-time

Medical, Retirement

Re-posted 22 days ago

Job description

Worker’s Compensation Claims Examiner - Full-time

Location: Spring Valley, NY

Required Qualifications:

  • Bachelor's degree.

  • Professional designation such as CPCU, ARM, CRM, or similar.

  • Proficient in Microsoft Office and adaptable to learn other software applications.

  • Excellent oral and written communication skills.

  • Detail-oriented with a high accuracy rate.

  • Strong critical thinking and organizational skills.

  • Ability to problem-solve and use good judgment.

  • Self-motivated with excellent time management skills.

  • 5+ years adjusting workers' compensation claims in multiple jurisdictions.

  • Experience in NY, NJ, and PA preferred, with NY experience required.

  • Healthcare industry experience.

  • Construction industry experience.

  • 5-7 years experience as a Workers Comp loss time claim adjuster.

Job Description

  • Investigate and manage workers' compensation claims in multiple jurisdictions.

  • Coordinate with nurse case managers, counsel, external vendors, and insureds for efficient claims handling.

  • Complete and document initial loss investigations to determine compensability.

  • Establish initial and subsequent reserves for anticipated exposure.

  • Review medical bills for a causal relationship to reported claims.

  • Liaison with insureds, nurse case managers, and counsel to oversee claim management and facilitate return to work.

  • Develop and maintain action plans to ensure reserve adequacy and timely resolution of claims.

  • Negotiate settlement of claims within designated authority.

  • Prepare and present claim review summaries for insureds, brokers, and internal contacts as requested.

  • Participate in discussions with insureds and counsel on strategies for successful claim closure.

  • Provide guidance and assistance to insureds and brokers on timely reporting of claims.

  • Manage insured onboarding, including training on claims reporting and use of the insured portal.

Benefits:

  • Great work-life balance

  • Market leader in commercial insurance and risk management

  • Offer a wide range of career paths and opportunities for growth

  • Competitive Compensation and Benefits: health insurance, retirement plans, and other benefits

Employment Type: FULL_TIME

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