Claims Examiner III (Workers Compensation)

TL;DR

Claims Examiner III (Workers Compensation): Managing high-complexity and high-exposure workers compensation claims across multiple jurisdictions with an accent on coverage analysis, investigation, and medical management. Focus on driving claims to resolution, negotiating settlements, and ensuring compliance with state regulations and internal quality standards.

Location: Must be based in Omaha, NE (Onsite)

Company

hirify.global Group is a Fortune 500 holding company specializing in insurance, reinsurance, and specialist advisory services with a global presence.

What you will do

• Confirm claim coverage by reviewing policies and submitted documentation.
• Conduct and direct investigations into loss facts and extent of damages.
• Evaluate compensability and medical management to determine insured exposure.
• Set reserves within authority and provide recommendations for reserve changes.
• Negotiate and settle claims with a focus on returning injured parties to work.
• Prepare detailed reports and monitor assignments to outside counsel and experts.

Requirements

• US Work Authorization required (no sponsorship provided).
• Experience in insurance or a business-related degree.
• Strong analytical, problem-solving, and organizational skills.
• Intermediate proficiency in Microsoft Office (Excel, Outlook, PowerPoint, Word).
• Ability to travel for mediations, trials, and conferences as required.
• Excellent written and oral communication skills.

Nice to have

• Insurance designation.
• Knowledge and understanding of medical terminology.

Culture & Benefits

• Comprehensive health, dental, and vision insurance plans.
• 401(k) retirement plan with employer match.
• Employee Stock Purchase Plan.
• Paid Time Off (PTO), corporate holidays, and parental leave.
• Supportive global community focused on continuous improvement and professional growth.