Claims Examiner III (Hybrid)

Tristar Insurance
Fresno, CA
Category Insurance
Job Description
Role Overview

Under general supervision, manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office.

What You Will Do

Effectively manages a caseload of 150 to 180 workers’ compensation files, including complex claims. Determines compensability of claims and administers benefits, based upon state law and in accordance with established Company guidelines.

Why It Might Be a Fit

This role requires excellent written and verbal communication skills, including ability to convey technical details to claimants, clients, and staff. Ability to interact with persons at all levels in the business environment and independently and effectively manage very complex claims.

Requirements

  • Bachelor’s degree in related field (preferred)
  • One (1) to five (5) years related experience
  • Technical knowledge of statutory regulations and medical terminology
  • Analytical skills
  • Certification and/or license as required by State regulation

Benefits

  • Medical, Dental, Vision Insurance
  • Life and Disability Insurance
  • 401(k) Plan
  • Paid Holidays
  • Paid Time Off
  • Referral bonus
]]>