Workers’ Compensation Claims Examiner

Insurance Placement Solutions (IPS) has an immediate opening for a Workers’ Compensation Claims Examiner with our client. This is a fully remote direct-hire opportunity for candidates located in the Central Time Zone, with preference given to adjusters located in Texas. In this role, you’ll manage a complex caseload of indemnity workers’ compensation claims from inception through resolution while ensuring compliance with Texas statutes, company guidelines, and client service expectations.

Workers’ Compensation Claims Examiner III Responsibilities

• Independently manage a caseload of approximately 150 workers’ compensation indemnity claims, including highly complex files
• Investigate claims and determine compensability in accordance with Texas workers’ compensation laws
• Administer indemnity benefits, including Temporary Income Benefits (TIBs), Impairment Income Benefits (IIBs), Supplemental Income Benefits (SIBs), Lifetime Income Benefits (LIBs), and Death Benefits
• Coordinate and authorize appropriate medical treatment and medical billing
• Establish and maintain appropriate claim reserves within assigned authority
• Direct and manage defense counsel on litigated claims as needed
• Communicate with claimants, medical providers, employers, attorneys, and vendors throughout the life of the claim
• Maintain accurate claim documentation and diary management to ensure timely claim progression
• Identify injury trends and communicate significant claim developments to clients
• Partner with loss control and other internal resources to support effective claim resolution
• Conduct independent file reviews and ensure compliance with company policies and regulatory requirements

Qualifications

• Minimum of 5 years of experience in handling workers’ compensation claims
• Demonstrated experience administering TIBs, IIBs, SIBs, LIBs, and Death Benefits
• Strong knowledge of Texas workers’ compensation statutes and claims handling procedures
• Experience handling complex and litigated workers’ compensation claims
• Excellent analytical, negotiation, organizational, and communication skills
• Ability to independently manage a high-volume, complex caseload
• Proficiency with Microsoft Word and Excel

Licensing

• Active Texas Workers’ Compensation License is required

Education

• Bachelor’s degree preferred or equivalent combination of education and experience

Work Arrangement

• Fully remote position for candidates located in Texas
• Direct hire opportunity

About Insurance Placement Solutions

Insurance Placement Solutions is a staffing and recruiting firm specializing in the insurance industry. Our clients rely on us to quickly fill direct hire, temporary, and temp-to-hire openings while maintaining operational continuity. We provide job seekers access to exclusive opportunities with leading insurance organizations that are often not advertised publicly.

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