Workers Compensation Claims Examiner I

TRISTAR Insurance Group

. Manage all aspects of Medical Only workers' compensation claims from inception to conclusion under established authority and guidelines .

Posted 11/11/2026full-timeLake Oswego • Oregon • United StatesJunior💰 $24 - $30 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing Medical Only workers' compensation claims, including determining claim compensability and managing medical treatment and billing. Proficient in communication with claimants and providers, while adhering to statutory regulations and company policies.

Highest-signal resume keywords

Medical Only Workers' Compensation Claims ManagementClaim Compensability DeterminationOR or WA Adjuster's LicenseTechnical Knowledge of Medical TerminologyExcellent Written and Verbal Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementMedical BillingDiary System MaintenanceAnalytical SkillsProficiency in WordProficiency in Excel

Soft Skills

Effective CommunicationInterpersonal SkillsProblem-Solving Skills

Tools & Technologies

Office EquipmentComputersFax MachinesCopiersPrinters

Certifications & Qualifications

OR Adjuster's LicenseWA Adjuster's License

Industry Keywords

Workers' CompensationStatutory RegulationsMedical TreatmentClaims AssistantFile Reviews

About the role

Key responsibilities & impact

Manage all aspects of Medical Only workers' compensation claims from inception to conclusion under established authority and guidelines
Manage a caseload of 150 to 200 Medical Only workers’ compensation files
Determine claim compensability
Manage medical treatment and medical billing
Communicate with claimants, providers, and vendors regarding claims issues
Maintain the diary system for case review and document files to reflect claim status and work performed
Communicate appropriate information promptly to clients to resolve claims efficiently
Adhere to company policies and procedures
Participate in file reviews as needed
Assist as a claims assistant when assigned
Use computers, fax machines, copiers, printers, and other office equipment

Requirements

What you’ll need

High School Diploma or GED is listed as the education level
Bachelor's degree in a related field preferred
One (1) year of related experience, or equivalent combination of education and experience
OR or WA adjuster's license required, or willingness to obtain the required licenses
Technical knowledge of statutory regulations and medical terminology
Analytical skills
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
Proficiency in Word and Excel preferred
Certification and/or license in OR and WA, or ability to become certified
Ability to perform the stated mental and physical requirements, including light work and frequent communication, hearing, and repetitive wrist, hand, and finger motions