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Worker Compensation Claims Examiner III
TRISTAR Insurance GroupWorker Compensation Claims Examiner managing complex indemnity claims for TRISTAR. Handling investigations, benefits administration, and communication with all stakeholders in the claims process.
Posted 6/30/2026full-timeRemote • Texas • 🇺🇸 United StatesMid-LevelSenior💰 $60,000 - $75,000 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing indemnity claims, including investigations, compensability determinations, and medical treatment management. Proficient in communication with claimants and vendors, ensuring compliance with statutory regulations and effective claims resolution.
Highest-signal resume keywords
Indemnity Claims ManagementTexas Workers Compensation LicenseStatutory Regulations KnowledgeAnalytical SkillsExcellent 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 HandlingCompensability DeterminationMedical Treatment ManagementCase ReviewReserves Computation
Soft Skills
Analytical SkillsEffective Management
Tools & Technologies
Microsoft WordMicrosoft Excel
Certifications & Qualifications
Texas Workers Compensation License
Industry Keywords
Workers CompensationClaims InvestigationClaims SettlementMedical TerminologyClaims Documentation
About the role
Key responsibilities & impact- Manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines
- Effectively manages a caseload of 150 workers’ compensation files
- Initiates and conducts investigations in a timely manner
- Determines compensability of claims and administers benefits
- Manages medical treatment and billing
- Refers cases to outside defense counsel and directs as appropriate
- Communicates with claimants, providers and vendors regarding claims issues
- Computes and sets reserves within Company guidelines
- Settles and/or finalizes all claims
- Maintains diary system for case review and documents file status
- Communicates appropriate information promptly to the client
Requirements
What you’ll need- Bachelor’s degree in related field (preferred)
- Three (3) or more years related experience
- Technical knowledge of statutory regulations and medical terminology
- Analytical skills
- Excellent written and verbal communication skills
- Ability to independently and effectively manage very complex claims
- Proficient in Word and Excel (preferred)
- Texas Workers Compensation License
Benefits
Comp & perks- Medical, Dental, Vision Insurance
- Life and Disability Insurance
- 401(k) Plan
- Paid Holidays
- Paid Time Off
- Referral bonus