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TEEMA Group

Workers Compensation Claims Examiner CO (Hybrid)

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What they do

A Claims Examiner evaluates insurance claims in accordance with applicable contracts and government regulations within their insurance type. Determines member eligibility and financial responsibility of the insurance company.

$82,494 / year median in Colorado

-1% projected decline

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Job Description

Workers' Compensation Claims Examiner III — Denver Metro (Hybrid) $80,000 to $90,000/year Full Benefits Package w/ PTO TEEMA Solutions has partnered with our client, a well-established third-party claims administrator, to add an experienced Workers' Compensation Claims Examiner to their Colorado operation. This is a full desk of indemnity work — you own your files from first report through resolution, with the authority and the support to actually move them. If you know Colorado comp cold and you'd rather manage a caseload than be managed, this is a strong seat. What You'll Do Manage an active caseload of approximately 150 workers' compensation files, spanning medical-only, indemnity, lifetime medical, and permanent partial benefit claims Initiate and conduct timely claims investigations Determine compensability and administer benefits in accordance with state law and established company guidelines Manage medical treatment and medical billing, authorizing care as appropriate Compute and set reserves within company authority levels Maintain a disciplined diary system for case review, documenting file status and work performed Communicate proactively with claimants, providers, vendors, and clients — including flagging injury trends and safety-related concerns Participate in client file reviews as needed Handle claims in other jurisdictions as assigned What You Bring High School Diploma or GED required; Bachelor's degree in a related field preferred Two (2)+ years of related workers' compensation claims experience, or an equivalent combination of education and experience Working knowledge of Colorado workers' compensation statutes and benefit administration Strong analytical skills and sound, independent judgment on compensability decisions Excellent written and verbal communication — you can translate technical claim detail for claimants, clients, and internal staff cleanly Comfort interacting with all levels of a business environment Proficiency in Microsoft Word and Excel preferred Details Hybrid position in Lakewood, CO. If you are looking for a great new opportunity to grow within Insurance, submit your resume now!