Claims Examiner

Company: Imagine Staffing Technology
Location: Long Beach
Posted on: December 30, 2025

Job Description:

Job Description Job Description Job Title : Claims Examiner Location : USA Hire Type : Contingent Pay Range : $40.00/hour Work Type : Full-time Work Model : Remote Work Schedule : Monday – Friday, 8:30am – 4:30pm Recruiter Contact : Sean Craft, sean@marykraft.com Nature & Scope: Positional Overview We are seeking an experienced Workers’ Compensation Claims Examiner to manage complex and high-exposure claims. This role is responsible for analyzing technically difficult workers’ compensation claims, determining benefits due, managing litigation and rehabilitation cases, and ensuring claims are adjudicated in compliance with service expectations, the best industry practices, and client-specific requirements. The Claims Examiner will also identify subrogation opportunities and negotiate settlements within designated authority. Role & Responsibility: Tasks That Will Lead to Your Success Analyze and process complex or technically difficult workers’ compensation claims by conducting investigations and gathering relevant information to determine claim exposure. Develop and manage well-structured action plans to drive timely and appropriate claim resolution. Negotiate settlements within assigned authority levels. Calculate, assign, and manage appropriate claim reserves throughout the life of the claim. Calculate and authorize benefit payments, adjustments, and settlements in a timely manner. Prepare and submit required state filings within statutory guidelines. Manage the litigation process to ensure cost-effective and timely claim resolution. Coordinate vendor referrals for investigations, medical management, and litigation support. Apply cost containment strategies, including the use of strategic vendor partnerships, to reduce overall claim costs. Manage claim recoveries, including subrogation, Second Injury Fund recoveries, and Social Security and Medicare offsets. Report claims to excess carriers and respond to inquiries and direction requests promptly and professionally. Communicate claim status and activity with claimants and clients while maintaining strong professional relationships. Ensure accurate claim documentation and proper claims coding within claim files. Escalate cases to supervisors or management as appropriate. Skills & Experience Qualifications That Will Help You Thrive Bachelor’s degree from an accredited college or university preferred. Professional certification related to workers’ compensation or claims management preferred. Minimum of five (5) years of claims management experience, or an equivalent combination of education and experience. Subject matter expertise in workers’ compensation insurance principles, laws, recoveries, offsets, deductions, and disability duration. Knowledge of cost containment practices, medical management, and Social Security and Medicare application procedures. Excellent verbal and written communication skills, including presentation abilities. Strong analytical, interpretive, and organizational skills. Excellent negotiation and interpersonal skills. Proficiency with Microsoft Office and general PC applications. Ability to work collaboratively in a team environment. Proven ability to meet or exceed established service expectations.

Keywords: Imagine Staffing Technology, Victorville , Claims Examiner, Legal , Long Beach, California