Workers Compensation Claims Examiner III _ (Temp to Full-time Hire)

Job Details Level: Experienced•Location: Houston Office - Houston, TX 77040•Position Type: Full Time•Education Level: High School Diploma or GED•Salary Range: $73,000.00 - $88,000.00•Travel: None•Shift: Day•Job Category: Admin - Clerical Hybrid position for employees residing in Houston, TX; remote work possible for those outside Houston with occasional in‑person meetings. Position Summary Under minimal supervision, manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. Responsibilities Effectively manages a caseload of 110 to 150 workers’ compensation files, including very complex claims. Initiates and conducts investigations in a timely manner. Determines compensability of claims and administers benefits based on state law and company guidelines. Manages medical treatment and billing, authorizing as appropriate. Communicates with claimants, providers, and vendors regarding claim issues. Computes reserves within company guidelines. Maintains diary system for case review and documents file status. Provides timely information to clients to resolve claims efficiently, including trends or safety concerns. Adheres to all company policies and procedures. Conducts file reviews independently. Other duties as assigned. Qualifications Education/Experience: High School Diploma or GED required. Bachelor’s degree in related field preferred; five (5) or more years of related experience, or equivalent combination of education and experience. Knowledge, Skills, and Abilities: Technical knowledge of statutory regulations and medical terminology. Analytical skills. Excellent written and verbal communication abilities, including conveying technical details. Effective interaction with persons at all levels. Independent and effective management of complex claims. Proficiency in Word and Excel preferred. Other Qualifications: Texas Workers Compensation License. Physical & Mental Requirements Candidate must be able to perform tasks requiring sustained mental focus and physical effort, including: Lifting, carrying, or moving objects up to 20 pounds. Standing, walking, and performing repetitive finger movements. Reading, writing, and operating office equipment. Responding to voice and written communication accurately. Equipment Used/Operated Computer, 10‑key, fax machine, copier, printer, and other office equipment. Special Equipment or Clothing Appropriate office attire. #J-18808-Ljbffr