Claims Examiner II

Benefits: Health insurance Opportunity for advancement Paid time off Vision insurance 401(k) matching Competitive salary Dental insurance Purpose: Employer's Claim Management is in the business of helping people. We help employees that have been injured by a work-related accident. We help employers by promoting workplace safety in their business. We believe that we are stronger when we work together. We work together each day to challenge ourselves and help each other be better. We aim to serve claimants, employees and each other. Above all we want to have a positive impact on those that we meet and serve each day. We believe that together we can make a difference. If you want to make a difference join the team at Employer's Claim Management. Position Description: We are seeking an Experienced Workers' Compensation Claims Examiner II with a strong back ground in Alabama workers' compensation claims handling. This role is designed for a knowledgeable, self-directed professional who can manage a full caseload, apply Alabama Workers' Compensation law with confidence, and build trusted relationships with all parties involved in the claim process. The ideal candidate values teamwork, communicates effectively, and brings sound judgement to claim evaluation, reserving, and resolution. Qualifications: Minimum of 3 years of Alabama workers' compensation claims handling experience is desirable. Knowledge of Alabama Workers' Compensation law and proven experience applying the law to claims. Good working knowledge of medical and legal terminology related to workers' compensation. Ability to analyze complex information, evaluate exposure, and make informed decisions regarding compensability, benefits, and settlement. Excellent verbal and written communication skills. Good communication skills and ability to communicate effectively with claimants, employers, physicians, nurses, insurance agents, and attorneys. Strong interpersonal skills and the ability to work collaboratively within a team environment. Demonstrated time management and organizational skills with the ability to manage multiple claims efficiently. Proficiency with Microsoft Office products and claims management technology. Self-motivated professional who values accuracy, accountability, and continuous learning. Key Responsibilities: Develop professional relationships with claimants, employers, medical providers, attorneys, and vendors. Independently manage a full caseload of Alabama workers' compensation claims from inception through resolution. Conduct thorough investigations to determine compensability and identify potential defenses. Establish, review, and maintain appropriate claim reserves. Calculate and issue workers' compensation indemnity and medical benefit payments accurately and timely. Maintain regular communication with employers, providing clear status updates and strategic recommendations. Personal visits to claimant as necessary on catastrophic or other complex claims. Coordinate and collaborate with nurse case managers, investigators, and other outside vendors as needed. Negotiate and resolve claims within assigned authority. Work closely with legal counsel on litigated claims, including discovery assistance, strategy development, and resolution planning. Travel to mediations, depositions, trails, meetings with employers/medical vendors and to workshops/seminars as necessary. Ensure complete, accurate, and timely documentation of all claim activity in the claims management system. Serve as a resource to team members by sharing expertise and best practices as needed. Compensation: We provide a competitive compensation and benefit package including medical, dental, vision, short-term disability, long-term disability and life insurance. Also, provided is company matched 401(K), flex spending account, personal time off and medical days. We believe great claims handling starts with people. We value teamwork, mutual respect, accountability, and continuous improvement. Our claims examiners are trusted professionals who are supported in doing meaningful work that makes a difference for injured employees and the employers who rely on us. EEO Statement Employer’s Claim Management, Inc. (ECMI) is an equal opportunity employer. The company will not discriminate or permit discrimination against any applicant or employee on the basis of age, race, color, sex, sexual orientation, gender identity, handicap, religion, national origin, disability, veteran or disability status, political affiliation or any other reason prohibited by law. This applies to all terms and conditions of employment including but not limited to hiring practices, work environment, job status, compensation, benefits, advancement opportunities, and termination. Flexible work from home options available. #J-18808-Ljbffr