Claims Examiner LV

Job Profile
Job Title	Workers Compensation Claims Examiner
Location	Remote
Hire Type	Contingent
Hourly	$45 - $47
Work Model	Monday – Friday
Contact Phone	(443)-345-3305
Contact Email	sean@marykraft.com

Nature & Scope:

Positional Overview

Mary Kraft is seeking an experienced Claims Examiner to handle complex and high-exposure workers’ compensation claims. The ideal candidate will have a strong background in claims investigation, litigation management, and benefit determination. This role requires expertise in Nevada workers’ compensation laws and an active NV adjuster license.

Role & Responsibility:

Tasks That Will Lead To Your Success

Analyze and process complex or technically difficult workers’ compensation claims to determine benefits due and ensure compliance with industry best practices and client requirements.
Litigation & Negotiation: Manage high-exposure claims, handle litigation cases, and negotiate settlements within designated authority levels.
Reserves & Payments: Assign timely and appropriate reserves, oversee claim payments, and make necessary adjustments throughout the claim lifecycle.
Regulatory Compliance: Prepare and submit state filings within statutory limits and ensure all claims meet regulatory requirements.
Cost Containment: Implement cost reduction strategies, manage vendor partnerships, and oversee subrogation efforts to optimize claim outcomes.
Communication & Reporting: Maintain clear and professional communication with claimants, clients, and legal teams, ensuring all claims are properly documented and coded.
Collaboration: Work closely with supervisors and management to escalate complex cases when necessary.

Skills & Experience:

Qualifications That Will Help You Thrive

Minimum 5+ years of workers’ compensation claims experience, specifically in Nevada.
Must be a Nevada resident and hold an active NV adjuster license.
Education: High School Diploma or GED required; bachelor’s degree preferred.
Technical Skills: Proficiency in Microsoft Office, claims management systems, and industry-specific software.
Soft Skills:
Strong analytical and problem-solving skills
Excellent written and verbal communication
Effective negotiation and conflict resolution
Strong organizational and time management abilities
Ability to work independently and in a team-oriented environment