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 ManagementOR or WA Adjuster’s LicenseTechnical Knowledge of Statutory RegulationsExcellent Written and Verbal Communication SkillsProficiency in Word and Excel

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementMedical BillingClaim Compensability DeterminationDiary System MaintenanceAnalytical Skills

Soft Skills

Communication SkillsInterpersonal SkillsOrganizational Skills

Tools & Technologies

Office EquipmentComputersFax MachinesPrintersCopiers

Certifications & Qualifications

Adjuster’s License in OR or WACertification in OR and WA

Industry Keywords

Workers’ CompensationMedical TerminologyClaims ExaminationClaims Assistant

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
Promptly communicate appropriate information to clients to resolve claims efficiently
Adhere to company policies and procedures
Participate in file reviews as needed
Assist as a claims assistant and perform other assigned duties
Use computers, fax machines, copiers, printers and other office equipment
Interact with clients, claimants, management, other Claims Examiners and TRISTAR staff

Requirements

What you’ll need

High School Diploma or GED 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
Certification and/or license in OR and WA, or ability to become certified
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
Ability to work consistently and punctually in the office or home office location
Appropriate office attire
Ability to perform light work and associated physical activities, including standing, walking, pushing, pulling, lifting, fingering and grasping
Near, mid-range and far vision; depth perception and field of vision requirements
Ability to talk, hear and perform repetitive wrist, hand and finger motions