Claims examiner [h1.location_city]
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Claims examiner • philadelphia pa
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Workers Compensation Claims Examiner III
TEEMAPhiladelphia, Pennsylvania[job_card.variable_hours_ago]
[job_preview.job_type]
- [job_card.full_time]
- [job_card.permanent]
[job_card.job_description]Manage 125–150 workers’ compensation claims , including high-complexity cases Handle claims from initial reporting through resolution Investigate claims and determine compensability in accordance with PA & NJ state laws Administer benefits and manage medical treatment and billing Set and manage reserves within established authority Coordinate with and direct outside defense counsel when needed Communicate effectively with claimants, medical providers, vendors, and internal stakeholders Maintain accurate documentation and diary management Identify claim trends and escalate issues appropriately Conduct independent file reviews Adhere to company policies, procedures, and ethical standards 3–5+ years of workers’ compensation claims experience Hands-on experience handling both PA and NJ claims (required) Experience managing indemnity and complex claims Strong working knowledge of statutory regulations and medical terminology Ability to work independently with minimal supervision Strong written and verbal communication skills Proficiency with claims systems and Microsoft Word / Excel Hybrid or in-office schedule (preference for PA-based candidates) Professional business-casual environment Collaborative claims operation with experienced leadership Financially strong, privately held organization Competitive salary with long-term growth potential Complex claims exposure that builds career value Ethical, people-first company culture High visibility role with stability and structure
Workers’ Compensation Claims Examiner III (PA & NJ)
Compensation : $85,000 – $92,000 base salary
Employment Type : Full-Time | Direct Hire
About the Opportunity
We've partnered with a well-established, nationally recognized third-party claims administration organization within the insurance and risk management industry. This organization has been in operation for decades and supports clients across workers’ compensation, property & casualty, benefits administration, and managed care services.
They are known for their financial stability, ethical leadership, and employee-first culture , offering long-term career growth rather than short-term churn. This role is part of an expanding claims operation and has strong visibility within the organization.
Position Overview
The Workers’ Compensation Claims Examiner III is responsible for managing the full lifecycle of indemnity workers’ compensation claims for Pennsylvania and New Jersey jurisdictions. This role handles a complex caseload and requires strong technical knowledge, independent judgment, and excellent communication skills.
This is an ideal opportunity for an experienced examiner who wants :
- Stability
- Competitive compensation
- Complex claims exposure
- A respected employer with national reach
Key Responsibilities
Required Qualifications
Licensure : No license required
Education : Bachelor’s degree preferred (or equivalent experience)\
Work Environment
Why Apply?
APPLY NOW!
Qualified candidates with PA and NJ workers’ compensation experience are encouraged to apply. Applications will be reviewed quickly, and qualified candidates will be contacted promptly.