Job Overview:
Our client, a Regional Insurance Company, is seeking a dedicated Senior Examiner to join their team. As a Senior Examiner, you will play a crucial role in analyzing and investigating insurance claims, particularly in the realm of Workers' Compensation. Your expertise will contribute to fraud prevention and detection efforts, ensuring compliance with Workers' Compensation law .
Responsibilities:
- Investigate claims to determine validity and extent of liability.
- Handle mid to complex Workers' Compensation Lost Time claims in Michigan
- Properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses, and others; coordinate medical treatment for injured workers.
- Determine if claims are valid under applicable workers' compensation statutes.
- Review and evaluate documentation, including applications, reports, and statements.
- Communicate with medical providers to develop and authorize treatment plans.
- Ensure legal, regulatory, and fair claims handling compliance.
- Set or recommend reserves based on results of claim investigation.
Requirements:
- 3 - 7+ years of Workers' Compensation Lost Time claims handling experience
- Must be well-versed in Michigan Workers’ Compensation Law
- Active MI Adjusters license
- Excellent Customer Service and Organizational skills
- High School Diploma; Bachelor's Degree preferred but not required
Job Type: Full-time
Pay: $80,000.00 - $95,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Family leave
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
Work setting:
Location:
- Redford, MI 48239 (Preferred)
Work Location: Hybrid remote in Redford, MI 48239