Workers Compensation Claims Examiner II

TRISTAR Insurance Group

. Manage workers’ compensation indemnity claims of moderate to complex difficulty from inception through resolution .

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 indemnity claims, including calculating reserves, authorizing payments, and handling complex claims independently. Strong analytical and communication skills are essential for effective interaction with clients and stakeholders.

Highest-signal resume keywords

Workers' Compensation Claims ManagementClaims HandlingStatutory Regulations KnowledgeAnalytical SkillsExcellent Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementReserve CalculationPayment AuthorizationComplex Claims HandlingLitigation Monitoring

Soft Skills

Independent JudgmentInterpersonal SkillsProblem-Solving

Tools & Technologies

Microsoft WordMicrosoft Excel

Certifications & Qualifications

State Certification or License

Industry Keywords

Workers' CompensationIndemnity ClaimsMedical TerminologyClaims ExposureSettlement Strategy

About the role

Key responsibilities & impact

Manage workers’ compensation indemnity claims of moderate to complex difficulty from inception through resolution
Exercise independent judgment in routine and complex claims handling
Seek supervisory guidance on unusual, high-exposure, or sensitive matters
Manage a caseload of approximately 150–180 workers’ compensation claims
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 assigned authority
Refer claims to defense counsel as appropriate
Monitor litigation activities
Consult with the supervisor on significant legal developments and settlement strategy

Requirements

What you’ll need

Bachelor’s degree in related field (preferred)
Three (3) to five (5) years related experience
Equivalent combination of education and experience accepted
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
Proficient in Word and Excel (preferred)
Certification and/or license as required by State regulation