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Workers Compensation Claims Examiner III (Remote)

TRISTAR Insurance Group · Waukesha, Wisconsin, US

Level: ExperiencedJob Location: Milwaukee - Waukesha, WI 53186Position Type: Full TimeEducation Level: Bachelor's DegreeSalary Range: $70,000. 00 - $85,000.

Job description

Job DetailsLevel: ExperiencedJob Location: Milwaukee - Waukesha, WI 53186Position Type: Full TimeEducation Level: Bachelor's DegreeSalary Range: $70,000.00 - $85,000.00 Salary/yearTravel Percentage: NegligibleJob Shift: DayJob Category: InsurancePOSITION SUMMARY: 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 on time is inherently required of this position. DUTIES AND RESPONSIBILITIES: Effectively manages a caseload of 150 or fewer workers’ compensation files, including complex claims.* Initiates and investigates promptly.* Determines compensability of claims and administers benefits based upon state law and following established Company guidelines.* Manages medical treatment and medical billing, authorizing as appropriate.* Refers cases to outside defense counsel. Directs and manages as appropriate.* Communicates with claimants, providers, and vendors regarding claims issues....