Claims Examiner

Job Overview 3 years of Workers Compensation Claim Examiner or commensurate experience. Experience in workers compensation is not required but advantageous if transferable skills are present. Responsibilities Handles all aspects of workers compensation claims from set‑up to case closure ensuring strong customer relations are maintained throughout the process. Reviews claim and policy information to provide information for investigation. Conducts 3‑part ongoing investigations obtaining facts and taking statements as necessary with insured claimant and medical providers. Evaluates the facts gathered through the investigation to determine compensability of the claim. Informs insureds, claimants and attorneys of claim denials when applicable. Prepares reports on investigation settlements, denials of claims and evaluations of involved parties, etc. Timely administration of statutory medical and/or indemnity benefits throughout the life of the claim. Sets reserves within authority limits for medical indemnity and expenses and recommends reserve changes to Team Leader throughout the life of the claim. Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them. Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered. Works with attorneys to manage hearings and litigation. Controls and directs vendors, nurse case managers, telephonic case managers and rehabilitation managers on medical management and return‑to‑work initiatives. Complies with customer service requests including Special Claims Handling procedures, file status notes and claim reviews. Files workers compensation forms and electronic data with states to ensure compliance with statutory regulations. Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized. Works with in‑house Technical Assistants, Special Investigators, Nurse Consultants, Telephonic Case Managers and Team Supervisors to exceed customer expectations for exceptional claims handling service. Technical Skills & Competencies Claim Examiner position with prior experience in workers compensation or commensurate examiner experience in paralegal, short‑term / long‑term disability, auto personal injury protection / medical injury, general liability, medical billing or as a claim technical assistant for lost‑time claims. Requires knowledge of workers compensation statutes, regulations and compliance. Ability to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issues. Exceptional customer service and focus. Ability to openly collaborate with leadership and peers to accomplish goals. Demonstrates a commitment to a career in claims. Exceptional time management and multi‑tasking capabilities with consistent follow‑through to meet deadlines. Use analytical skills to find mutually beneficial solutions to claim and customer issues. Ability to prepare and make exceptional presentations to internal and external customers. Conscientious about the quality and professionalism of work product and relationships with co‑workers and clients. Willing to take ownership and tackle obstacles to meet Chubb's quality standards for service investigation, reserving, inventory management, teamwork and diversity appreciation. Superior verbal and written communication skills. Experience & Education Requirements Experience working in a customer‑focused fast‑paced fluid environment. Experience utilizing strong communication and telephonic skills. Prior experience requiring a high level of organization, follow‑up and accountability. Prior workers compensation claim handling experience is a plus but not required. Familiarity with claim handling healthcare, short‑term / long‑term disability, auto personal injury protection / medical injury, medical billing or general liability is a plus but not required. Prior insurance, legal or corporate business experience is a plus but not required. AIC, RMA or CPCU completed coursework or designations is a plus but not required. Proficiency with Microsoft Office products. Knowledge of medical terminology is a plus but not required. Knowledge of bill processing is a plus but not required. Claim Adjuster licenses in Connecticut, New Hampshire, Rhode Island and Vermont are necessary; however they are not required at the time of posting. If you do not already have one, you will be required to obtain an applicable resident or designated home state adjuster license and possibly additional state licensure. Job Details Contract position based out of New Haven, CT. Pay range: $33.00 – $35.00 per hour. Benefits for this temporary role, subject to eligibility and company policy, include: Medical, dental & vision. Critical Illness, Accident, and Hospital. 401(k) Retirement Plan – pre‑tax and Roth post‑tax contributions available. Life Insurance (Voluntary Life & AD&D for the employee and dependents). Short and long‑term disability. Health Spending Account (HSA). Transportation benefits. Employee Assistance Program. Time off / leave (PTO, vacation or sick leave). Workplace type: fully onsite in New Haven, CT. Application deadline: anticipated to close on Jun16, 2026. The company is an equal‑opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. #J-18808-Ljbffr