Workers Compensation Claims Examiner II

TRISTAR Insurance Group

. Manage approximately 150–180 workers’ compensation claims of moderate to complex difficulty .

Posted 10/3/2026full-timeIrving • Texas • United StatesMid-LevelSenior💰 $70,000 - $75,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing workers' compensation claims, including the ability to handle complex cases, calculate reserves, and authorize settlements while adhering to statutory regulations and company guidelines. Strong analytical and communication skills are essential for effective interaction with clients and stakeholders.

Highest-signal resume keywords

Workers' Compensation Claims ManagementIndemnity Claims HandlingStatutory Regulations KnowledgeAnalytical SkillsExcellent Written And Verbal Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementReserve CalculationPayment AuthorizationLitigation MonitoringTechnical Knowledge Of Medical Terminology

Soft Skills

Independent JudgmentInterpersonal SkillsProblem-Solving

Tools & Technologies

Microsoft WordMicrosoft Excel

Certifications & Qualifications

State Certification Or License

Industry Keywords

Workers' CompensationClaims HandlingIndemnity ClaimsLegal DevelopmentsClient Concerns

About the role

Key responsibilities & impact

Manage approximately 150–180 workers’ compensation claims of moderate to complex difficulty
Manage indemnity claims from inception through resolution within assigned authority limits and company/client guidelines
Calculate and establish reserves
Authorize payments and settlements within assigned authority limits
Identify and escalate claims involving significant exposure, unusual compensability issues, sensitive client concerns, or decisions exceeding authority
Refer claims to defense counsel as appropriate
Monitor litigation activities
Consult with the supervisor on significant legal developments and settlement strategy
Exercise independent judgment in routine and complex claims handling
Seek supervisory guidance on unusual, high-exposure, or sensitive matters

Requirements

What you’ll need

High School Diploma or GED listed as the education level
Bachelor’s degree in a related field (preferred)
Three (3) to five (5) years of related experience, or equivalent combination of education and experience
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 people at all levels in the business environment
Ability to independently and effectively manage very complex claims
Proficiency in Word and Excel (preferred)
Certification and/or license as required by State regulation