Claims Examiner

Acrisure

. Responsible for managing workers’ compensation claims as assigned by claims supervisor .

Posted 5/6/2026full-timeLas Vegas • Nevada • 🇺🇸 United StatesMid-LevelSenior💰 $105,110 per yearWebsite

About the role

Key responsibilities & impact

Responsible for managing workers’ compensation claims as assigned by claims supervisor
Investigates claims
Determines the compensability of the claim and extent of liability
Communicates directly with clients, employers, injured workers, physicians, and attorneys to bring claims to a timely conclusion
Interviews, telephones, or corresponds with claimant and witnesses; consults police and hospital records
Contacts physicians to obtain medical diagnoses and projected treatment plans
Monitors medical progress of claimants and coordinates follow-up treatments; reports to employers including any restrictions that may be imposed on claimants’ return to work
Documents all information from contacts with employers, claimants, physicians, and attorneys into the claims’ management system and ensures that documentation is current
Calculates and sets reserves through a reserve worksheet including the nature and scope of claims; adjusts reserves to reflect ultimate known exposures
Issues medical, indemnity, legal and expense payments
Prepares reports for excess carriers and requests reimbursement when needed
Sets reminders to follow-up on tasks through diaries on the system; reviews and completes diaries daily
Maintains physical files for claim-related documents such as medical information, legal reports, and other correspondence
Reviews claims’ submissions for thoroughness and accuracy
Determines compensability of claims through information gathered and according to workers’ compensation statutes; makes recommendations as to compensability and coverage of claims
Provides guidance and advice to clients on direction of claims after all information has been gathered and analyzed
Ensures jurisdictional filings are complete and timely
Obtains pre-certification approval for specific treatments as needed

Requirements

What you’ll need

Strong organization skills, attention to detail and the ability to multi-task and prioritize work are required
Analytical thinking skills are needed to properly evaluate complex claims
Good verbal and written communication skills, as well as interpersonal skills are required
Experience with negotiations, knowledge of litigation process is preferred
Ability to listen well and negotiate with constituents is needed
Ability to speak a second language is an asset
Basic computer skills or the ability to quickly learn new software are required
A strong work ethic and time management skills is needed, to efficiently handle a caseload ranging from minor to complex claims
Ability to establish and maintain good rapport with clients and claimants is needed
Ability to calculate figures is required
High school Diploma or equivalent is required
3+ years prior experience handling worker’s claims/ or an equivalent combination of training, education and experience
Adjuster licensing required; (Multiple jurisdictions will be involved, will be required to have a license that will reciprocate to other states.) CA, AZ, LA, NV and UT licensing a plus

Benefits

Comp & perks

Comprehensive medical insurance, dental insurance, and vision insurance
Life and disability insurance
Fertility benefits
Wellness resources
Paid sick time
Generous paid time off and holidays
Employee Assistance Program (EAP)
Complimentary Calm app subscription
Immediate vesting in a 401(k) plan
Health Savings Account (HSA) and Flexible Spending Account (FSA) options
Commuter benefits
Employee discount programs
Paid maternity leave and paid paternity leave (including for adoptive parents)
Legal plan options
Pet insurance coverage

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims managementinvestigationcompensability determinationmedical diagnosis coordinationreserve calculationreport preparationdocumentationnegotiationlitigation knowledgedata analysis

Soft Skills

organizationattention to detailmulti-taskinganalytical thinkingverbal communicationwritten communicationinterpersonal skillstime managementrapport buildinglistening

Certifications

adjuster licensinghigh school diploma or equivalent