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Workers Compensation Claims Auditor Jobs (NOW HIRING)

Coca-Cola Beverages Florida, LLC

$90 - $120/hr

Competitive compensation Coke Florida is searching for a Workers' Compensation Claims Manager to work out of our Tampa HQ office. What you'll do: Coca-Cola Beverages Florida is seeking an experienced ...

Acrisure

Workers Compensation Claims Examiner

Atlanta, GA · On-site +1

$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 ...

MGM Resorts International

$70 - $100/hr

THE JOB The primary purpose of the Workers' Compensation Claims Analyst is to manage the investigation and administration of all Workers' Compensation claims handled by Third-Party Administrators ...

New

Acrisure

Workers Compensation Claims Examiner

Mobile, AL

$32.50 - $44.25/hr

Acrisure is seeking a Workers' Compensation Claims Examiner to support clients within the Alabama jurisdiction. This role is responsible for managing lost time workers' compensation claims from ...

Acrisure

Workers Compensation Claims Examiner

Birmingham, AL · On-site

$30.75 - $41.75/hr

Acrisure is seeking a Workers' Compensation Claims Examiner to support clients within the Alabama jurisdiction. This role is responsible for managing lost time workers' compensation claims from ...

Greenlife Healthcare Staffing

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Workers Compensation Claims Examiner

Washington, DC · On-site

$42/hr

Workers' Compensation Claims Examiner - Washington, DC (#R10291) * Location: Washington, DC 20001 * Employment Type: Temporary / Full-Time * Hourly Rate: $42 per hour About Greenlife Healthcare ...

Acrisure

Workers Compensation Claims Examiner

Montgomery, AL · On-site

$32.50 - $44/hr

Acrisure is seeking a Workers' Compensation Claims Examiner to support clients within the Alabama jurisdiction. This role is responsible for managing lost time workers' compensation claims from ...

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Workers Compensation Claims Auditor information

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

As of Sep 2, 2026, the average hourly pay for workers compensation claims auditor in the United States is $26.83, according to ZipRecruiter salary data. Most workers in this role earn between $19.71 and $29.81 per hour, depending on experience, location, and employer.

What does a workers compensation claims auditor do?

A Workers Compensation Claims Auditor is responsible for reviewing and evaluating workers' compensation claims to ensure they are processed accurately and in compliance with legal and company policies. They examine claim files, payments, and supporting documentation to detect errors, fraud, or inefficiencies. Their work helps organizations manage costs, maintain regulatory compliance, and improve claims handling processes. Auditors often provide recommendations for process improvements and may train staff on proper procedures. This role is critical in preventing unnecessary losses and ensuring fair treatment for injured employees.

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

To thrive as a Workers Compensation Claims Auditor, you need in-depth knowledge of workers' compensation laws, claims processing, and auditing procedures, typically backed by experience in insurance or claims management. Familiarity with claims management systems, auditing software, and sometimes certifications like CPCU or AIC are highly valued. Strong analytical thinking, attention to detail, and effective communication are standout soft skills for this role. These abilities are crucial to ensure compliance, accuracy, and cost control in claims handling, ultimately protecting both employers and insurance carriers.

What are some common challenges faced by workers compensation claims auditors, and how can I prepare for them?

Workers Compensation Claims Auditors often encounter challenges such as staying current with changing state regulations, identifying inconsistencies in complex claims data, and managing a high volume of files while meeting strict deadlines. To prepare, it’s important to develop strong attention to detail, keep up-to-date on relevant legal requirements, and build effective communication skills for collaborating with claims adjusters and legal teams. Leveraging audit software and participating in ongoing training can also help you efficiently navigate these challenges and enhance your impact in the role.

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

AspectWorkers Compensation Claims AuditorWorkers Compensation Claims Adjuster
CredentialsTypically requires certifications like CPCU or ARM, with knowledge of insurance and auditingRequires state licensing, insurance adjuster licenses, and claims handling certifications
Work EnvironmentMostly office-based, reviewing claims and audit reportsField and office-based, investigating and settling claims
Employer & Industry UsageInsurance companies, third-party administrators, and auditing firmsInsurance carriers, third-party administrators, and self-insured employers

While both roles involve working with workers' compensation claims, the Claims Auditor primarily reviews and audits claims for accuracy and compliance, whereas the Claims Adjuster handles the investigation, negotiation, and settlement of claims. Understanding these differences helps in choosing the right career path or job search focus.

More about Workers Compensation Claims Auditor jobs

What cities are hiring for Workers Compensation Claims Auditor jobs?

Cities with the most Workers Compensation Claims Auditor job openings:

What states have the most Workers Compensation Claims Auditor jobs?

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

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

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

Workers Compensation Claims Auditor jobs near you
Infographic showing various Workers Compensation Claims Auditor 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 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $55,805 per year, or $26.8 per hour.

Workers' Compensation Claims Examiner

Greenlife Healthcare Staffing

Washington, DC • On-site

$42/hr

Temporary

Posted 6 days ago

Job description

Workers' Compensation Claims Examiner – Washington, DC

Location: Washington, DC
Employment Type: Temporary / Full-time
Rate: $42/hour

Position Overview:
The Claims Examiner administers workers' compensation claims from initial report through closure by investigating compensability, analyzing medical and employment evidence, making claim recommendations, coordinating services, maintaining claim records, and supporting hearings and settlements for the Public Sector Workers' Compensation Program.

Why You'll Love Working Here:
  • Competitive rate of $42/hour providing essential claims examination services for the Public Sector Workers' Compensation Program.
  • Temporary, full-time position.
  • Full-time, Monday–Friday, 8:30 AM–5:00 PM ET; up to 40 hours per week.
  • No work on District holidays or administrative closure days.
  • Valuable experience in a collaborative, supportive government office setting.
  • Mission-driven work improving outcomes for injured workers through professional claims administration and case management.

Qualifications:
  • Bachelor's degree and at least two years of workers' compensation claims adjusting experience; OR eight years of progressively responsible claims-handling experience, including at least three years of workers' compensation claims adjusting experience.
  • Knowledge of workers' compensation laws, regulations, investigations, reserving, case management, and claim adjudication.
  • Ability to analyze medical evidence and make claim determinations.
  • Experience participating in hearings, mediations, or settlement conferences.
  • Knowledge of medical terminology and treatment review.
  • Skilled in workers' compensation investigation, compensability analysis, reserving, adjudication, and caseload management.
  • Medical and claim-record analysis, factual findings, and written determinations.
  • Proficiency with claims management systems and Microsoft Office applications.
  • Stakeholder coordination, hearings and mediation support, customer service, and written and verbal communication.
  • Confidential and sensitive information handling.

Key Responsibilities:
  • Receive, review, and process first reports of injury, notices of loss, and workers' compensation claims under applicable laws, regulations, policies, and procedures.
  • Investigate and evaluate claims to determine compensability and entitlement to medical and related benefits.
  • Manage medical-only workers' compensation claims from inception through closure.
  • Collect and analyze medical records, employment records, witness statements, treatment plans, bills, and other claim evidence.
  • Review medical evidence for treatment appropriateness, medical necessity, work restrictions, and return-to-work opportunities.
  • Complete required claim contacts, including 24-hour four-point contacts with injured workers, supervisors, medical providers, and other stakeholders; document activity in the claims management system.
  • Develop factual findings, claim analyses, and recommendations supporting determinations and benefit decisions.
  • Coordinate with injured workers, agency representatives, healthcare providers, legal counsel, nurse case managers, and other stakeholders.
  • Coordinate medical appointments, independent medical evaluations, transportation services, and medically necessary follow-up care.
  • Assess maximum medical improvement, work capacity, and ongoing treatment needs using medical evidence and provider recommendations.
  • Draft notices, correspondence, claim determinations, and adjudication documents.
  • Maintain complete and timely claim files; research claim histories, laws, regulations, policies, and procedures.
  • Manage assigned caseloads to meet performance standards, statutory requirements, and customer-service expectations.
  • Participate in claim reviews, settlement discussions, mediations, hearings, and administrative proceedings; provide testimony or supporting documents when required.
  • Protect confidential medical, financial, and employment information and provide professional customer service.
  • Perform other related duties supporting the Public Sector Workers' Compensation Program.

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About Greenlife Healthcare Staffing

Sourced by ZipRecruiter

Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

New York, NY, US

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