New

Claims Examiner-Lost Time

TEKsystems
$37.00 - $38.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, Michigan, Grand Rapids
May 09, 2025
Duties and Responsibilities: - Handles all aspects of workers compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process. - Reviews claim and policy information to provide background for investigation. - Conducts 3-part ongoing investigations obtaining facts and taking statements as necessary with insured claimant and medical providers. - Evaluates the facts gathered through the investigation to determine compensability of the claim. - Informs insureds claimants and attorneys of claim denials when applicable. - Prepares reports on investigation settlements denials of claims and evaluations of involved parties etc. - Timely administration of statutory medical and indemnity benefits throughout the life of the claim. - Sets reserves within authority limits for medical indemnity and expenses and recommends reserve changes to Team Leader throughout the life of the claim. - Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them. - Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered. - Works with attorneys to manage hearings and litigation - Controls and directs vendors nurse case managers telephonic cases managers and rehabilitation managers on medical management and return to work initiatives. - Complies with customer service requests including Special Claims Handling procedures file status notes and claim reviews. - Files workers compensation forms and electronic data with states to ensure compliance with statutory regulations. - Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized. - Works with in-house Technical Assistants Special Investigators Nurse Consultants Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service. Experience Level Entry Level Pay and Benefits The pay range for this position is $37.00 - $38.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Grand Rapids,MI. Application Deadline This position is anticipated to close on May 16, 2025. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.