5 workers compensation claims examiner jobs found

The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.   This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and/or direct reporting manager   Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Utilize clinical and/or technical expertise to address the provision of medical care and identify inappropriate billing practices and errors, such as: duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time...

Play a key role in claims operations—handling records, payments, mail, and system tasks while working with customers and partners to resolve claims efficiently What You'll Do   As a Claims Technician, you will:   Analyze and process complex bills, checks, and invoices for proper coding and payment, including payments to law firms, claims suppliers, and injured workers. Research and resolve uncashed checks per company procedures, assist in securing IRS Form W-9 documents and ensure payments are coded properly.  Resolve title procurement issues with suppliers and customers. Coordinate document signatures with vehicle owners to align with state title compliance. Work with lenders to secure title and payoff information, letters of guarantee, and title copies.  Work with electronic claim documents. Compile, prepare, organize, review, and distribute moderate to complex claims materials to respond to various claims requests, including subpoenas, legal requests, and...

Crum & Forster Company Overview Crum & Forster (C&F) , with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.   Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work ® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.   C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.  For more information about Crum & Forster,...

Position Summary The Property and Casualty Underwriter is responsible for managing a portfolio of accounts and driving new and renewal business opportunities for Property and Casualty insurance. The role assesses risks associated with insuring properties and liabilities, evaluates applications, analyzes data, and determines coverage terms and premiums to ensure sound underwriting decisions. They develop and maintain underwriting practices and guidelines as per delegated authority and build relationships with brokers and other stakeholders in the designated portfolio. What will your job entail? Job Responsibilities: • Underwrites new and renewal property and casualty business, analyzes policy forms, broker endorsement requests, and submitted documentation as per company underwriting standards and guidelines and obtains additional information as needed. • Determines whether to accept, modify or decline a risk through evaluation of the coverage value, location, usage, safety...

Summary: The Personal Lines (PL) Claims Examiner is responsible for handling jewelry losses from our personal lines customers located in the United States and Canada. The causes of loss include, among others, damage, theft, and mysterious disappearance. Why Jewelers Mutual: Since 1913 we’ve been committed to supporting the Jewelry industry and putting customers at the center of everything we do. With over a century of trusted expertise, we’re financially strong, forward-thinking, and driven by curiosity. Guided by our core values of Agility, Accountability, and Relevancy, we lead through innovation. As a technology focused organization, we embrace cutting-edge tools and data-driven insights to continuously improve our products, services, and customer experience. Our mission is to be the industry’s most trusted advisor by investing in our people, adopting new technologies, and striving for excellence. We’re dedicated to fostering growth through collaboration, powered by...