Claims Examiner

Description Description Job Schedule:

5 days on-site

Job Hours:

8:30am-5:00pm

EST Location:

New Haven

CT USA 06511-5941

Interview Process:

1 round of interview

• Virtual 3 years of Workers Compensation Claim Examiner or Commensurate Experience Having experience in workers compensation is not a requirement but a nice thing to have as long as the skills they do have are transferable.

Duties and Responsibilities:

• Handles all aspects of workers compensation claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.
• Reviews claim and policy information to provide bg for investigation.
• Conducts 3-part ongoing investigations obtaining facts and taking statements as necessary with insured claimant and medical providers.
• Evaluates the facts gathered through the investigation to determine compensability of the claim.
• Informs insureds claimants and attorneys of claim denials when applicable.
• Prepares reports on investigation settlements denials of claims and evaluations of involved parties etc.
• Timely administration of statutory medical and/or indemnity benefits throughout the life of the claim.
• Sets reserves within authority limits for medical indemnity and expenses and recommends reserve changes to Team Leader throughout the life of the claim.
• Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.
• Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.
• Works with attorneys to manage hearings and litigation
• Controls and directs vendors nurse case managers telephonic cases managers and rehabilitation managers on medical management and return to work initiatives.
• Complies with customer service requests including Special Claims Handling procedures file status notes and claim reviews.
• Files workers compensation forms and electronic data with states to ensure compliance with statutory regulations.
• Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.
• Works with in-house Technical Assistants Special Investigators Nurse Consultants Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.

Technical Skills Competencies:

• Claim Examiner position with prior experience in workers compensation as a claim examiner or commensurate examiner experience in paralegal short-term / long-term disability auto personal injury protection / medical injury general liability medical billing or as a claim technical assistant for lost time claims.
• Requires knowledge of workers compensation statutes regulations and compliance.
• Ability to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issues.
• Exceptional customer service and focus.
• Ability to openly collaborate with leadership and peers to accomplish goals.
• Demonstrates a commitment to a career in claims.
• Exceptional time management and multi-tasking capabilities with consistent follow through to meet deadlines.
• Use analytical skills to find mutually beneficial solutions to claim and customer issues.
• Ability to prepare and make exceptional presentations to internal and external customers.
• Conscientious about the quality and professionalism of work product and relationships with co-workers and clients.
• Willing to take ownership and tackle obstacles to meet Chubb's quality standards for service investigation reserving inventory management teamwork and diversity appreciation.
• Superior verbal and written communication skills.

Experience Education Requirements:

• Experience working in a customer focused fast-paced fluid environment
• Experience utilizing strong communication and telephonic skills
• Prior experience requiring a high level of organization follow-up and accountability
• Prior workers compensation claim handling experience is a plus but not required
• Familiarity with claim handling healthcare short-term / long-term disability auto personal injury protection / medical injury medical billing or general liability is a plus but not required
• Prior insurance legal or corporate business experience is a plus but not required
• AIC RMA or CPCU completed coursework or designations is a plus but not required
• Proficiency with Microsoft Office Products
• Knowledge of medical terminology is a plus but not required
• Knowledge of bill processing is a plus but not required
• Claim Adjuster licenses in Connecticut New Hampshire Rhode Island and Vermont are necessary however they are not required at the time of posting for the position.

If you do not already have one you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure Additional Skills & Qualifications Helpful to understand insurance, but not required. Self starter-be willing to jump in with both feet, take direction, take initiative. Word/excel/teams/outlook exp 5-7 claims a day consisting of 3 calls for each claim. When they have their own desk they can handle about 100 phone calls a day-inbound and outbound. 5 days on site-new haven, on the waterfront

• Looking to convert within 90 days-180 days Can get their licnese 35 years Lev manager, majority of his team is newer 12-24 months.

30% of his staff has about 10 years industry exp, 40% has 5 years and other 30% less than 5 years industry. They can go anywhere international claims, property claims, etc there are a lot of growth Experience Level Entry Level Job Type & Location This is a Contract position based out of New Haven, CT. Pay and Benefits The pay range for this position is $36.00

• $37.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan
• Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in New Haven,CT.

Application Deadline This position is anticipated to close on Apr 17, 2026. h4>

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.