Workers' Compensation Claims Examiner III

TRISTAR Insurance Group

Workers' Compensation Claims Examiner managing indemnity claims handling from inception to conclusion. Engaging with clients and conducting investigations in a hybrid role based in Denver.

Posted 7/15/2026full-timeLakewood • Colorado • 🇺🇸 United StatesMid-LevelSenior💰 $80,000 - $90,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing indemnity claims from inception to conclusion, including investigation, compensability determination, and benefit administration. Proficient in statutory regulations and medical terminology, with strong analytical and communication skills to effectively handle complex claims.

Highest-signal resume keywords

Indemnity Claims ManagementClaims InvestigationCompensability DeterminationMedical Treatment ManagementSelf-Insured Claims Handling

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims HandlingBenefit CalculationReserve ComputationAction Plan DevelopmentMedical Billing Management

Soft Skills

Analytical SkillsExcellent Communication Skills

Tools & Technologies

Microsoft WordMicrosoft Excel

Industry Keywords

Statutory RegulationsMedical TerminologyCity Claims HandlingCounty Claims HandlingDistrict Claims Handling

About the role

Key responsibilities & impact

Manages all aspects of indemnity claims handling from inception to conclusion
Initiates and conducts investigation in a timely manner
Determines compensability of claims and administers benefits
Develops and manages claims through well-developed action plans
Manages medical treatment and medical billing
Calculates and pays benefits due and approves all claim payments
Manages claim recoveries of all types
Communicates with clients, claimants, providers, and vendors regarding claims issues
Computes and sets reserves within Company guidelines
Settles and/or finalizes all claims

Requirements

What you’ll need

Bachelor’s degree in related field (preferred)
Five (5) or more years of 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)
Knowledge of self-insured claims handling (preferred)
City, County and/or District claims handling experience (preferred)

Benefits

Comp & perks

Medical, Dental, Vision Insurance
Life and Disability Insurance
401(k) Plan
Paid Holidays
Paid Time Off
Referral bonus