Workers Compensation Claims Examiner III

Dallas - Irving, TX 75038

Salary Range: $76,000.00 - $80,000.00 Salary/year

Position Type:
Full Time

Job Shift:
Day

Education Level:
High School Diploma or GED

Travel Percentage :
None

Category:
Admin - Clerical

Workers Compensation Claims Examiner III

Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines.

This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; therefore consistently being at work in the office, in a timely manner, is inherently required of this position.

• Handle loss time Workers’ Compensation claims in TX Office—Texas Jurisdiction
• Handle claims as per BP , SOC 1 and client CHI’s
• The ability to prepare a formal captioned report on claims meeting client requirements
• Well organized and CAN DO attitude.
• Ability to effectively communicate in a professional manner
• Provide great customer service
• Assist employers and their employee’s understand the WC process
• Investigate, evaluate, determine compensability, pay benefits timely as required and comply with all statutory requirements
• A good sense of urgency
• Ability to get along well with others with a positive attitude

Computer, 10-key, fax machine, copier, printer, and other office equipment.

Follow company dress code

Education/Experience
:
High School Diploma or GED required;
Bachelor’s degree in related field (preferred); five (5) or more years related experience; or equivalent combination of education and experience.

Other Qualifications
:

Workers’ Compensation Adjusters License current for the State of Texas

1.
MENTAL EFFORT

a. Reasoning development:
Follow one- or two-step instructions; routine, repetitive task.

Carry out detail but uninvolved written or verbal instructions; deal with a few concrete variables.

Follow written, verbal, or diagrammatic instructions; several concrete variables.

Solve practical problems; variety of variables with limited standardization; interpret instructions.

Logical or scientific thinking to solve problems; several abstract and concrete variables.

Wide range of intellectual and practical problems; comprehend most obscure concepts.

b. Mathematical development:

Simple additional and subtraction; copying figures, counting, and recording.

Add, subtract, multiply, and divide whole numbers.

Arithmetic calculations involving fractions, decimals, and percentages.

Arithmetic, algebraic, and geometric calculations.

Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.

Highly complex mathematical and statistical techniques such as calculus, factor analysis, and probability determination; requires theoretical application.

c. Language development:

Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.

Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and provide basic direction.

Ability to transcribe dictation; make appointments and process mail; write form letters or routine correspondence; interpret written work instructions; interview job applicants.

Ability to compose original correspondence, follow technical manuals, and have increased contact with people.

Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.

2.
PHYSICAL EFFORT

a. Physical activity required to perform the job:

Sedentary work:
Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all…