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Workers' Compensation Claims Examiner III
TRISTAR Insurance GroupWorkers’ Compensation Claims Examiner managing indemnity claims for TRISTAR. Interacting with clients and handling complex claims investigations in a timely manner.
Posted 6/30/2026full-timeFresno • California • 🇺🇸 United StatesMid-LevelSenior💰 $84,000 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing workers' compensation claims, including conducting investigations, determining compensability, and administering benefits in compliance with state laws. Strong communication skills are essential for effective interaction with claimants, providers, and vendors.
Highest-signal resume keywords
Workers' Compensation Claims ManagementClaims InvestigationMedical Treatment ManagementStatutory Regulations KnowledgeExcellent Communication Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims AdministrationCompensability DeterminationMedical Billing AuthorizationTechnical Knowledge of Medical TerminologyCase Management
Soft Skills
Written CommunicationVerbal Communication
Tools & Technologies
Microsoft WordMicrosoft Excel
Industry Keywords
Workers' CompensationClaims ProcessingState Law Compliance
About the role
Key responsibilities & impact- Effectively manages a caseload of 150 to 180 workers’ compensation files, including complex claims
- Initiates and conducts claims investigation in a timely manner
- Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines
- Manages medical treatment and medical billing, authorizing as appropriate
- Communicates with claimants, providers and vendors regarding claims issues
Requirements
What you’ll need- Bachelor’s degree in related field (preferred)
- One (1) to five (5) years related experience; or equivalent combination of education and experience
- Technical knowledge of statutory regulations and medical terminology
- Excellent written and verbal communication skills
- Proficient in Word and Excel (preferred)
Benefits
Comp & perks- Health insurance
- Retirement plans
- Paid time off