Workers Compensation Claims Examiner | Nevada License

Insurance Placement Solutions (IPS) has an immediate opening for a Workers’ Compensation Claims Examiner with our client. This opportunity focuses on Nevada workers’ compensation claims and may be worked remotely or onsite. Onsite candidates are preferred; however, experienced candidates with an active Nevada adjuster license may be considered for fully remote work.

In this role, you’ll manage mid- to higher-level workers’ compensation claims, including long-term indemnity files. You’ll determine compensability and benefits, develop claim strategies, monitor reserves, coordinate return-to-work efforts, negotiate settlements, and manage claims toward timely resolution.

Workers’ Compensation Claims Examiner Responsibilities

• Manage mid- to higher-level workers’ compensation claims from assignment through resolution
• Determine compensability and administer appropriate workers’ compensation benefits
• Manage long-term indemnity claims and monitor reserve adequacy
• Develop and maintain claim action plans through resolution
• Coordinate return-to-work efforts with appropriate parties
• Approve and process claim payments within designated authority
• Prepare and file required documentation with applicable state agencies
• Identify and pursue subrogation opportunities
• Evaluate and negotiate claim settlements within designated authority
• Communicate claim activity and developments with claimants and clients
• Maintain accurate claim documentation and coding
• Manage complex lifetime medical and defined-period medical claims as assigned
• Evaluate treatment recommendations and utilization review information as appropriate
• Maintain professional client relationships throughout the claims process

Qualifications

• Minimum of 4 years of workers’ compensation claims handling experience
• Experience independently managing indemnity workers’ compensation claims
• Experience managing claims from compensability determination through resolution

Preferred

• Bachelor’s degree from an accredited college or university

Licensing & Certifications

• Active Nevada adjuster license required

Work Arrangement

• Onsite work preferred
• Fully remote candidates may be considered based on Nevada claims experience
• Remote candidates must hold an active Nevada adjuster license

About Insurance Placement Solutions

Insurance Placement Solutions is a staffing and recruiting firm specializing in the insurance industry. We connect talented professionals with temporary, temp-to-hire, and direct-hire opportunities at leading insurance organizations across the United States.

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