Workers Compensation Claims Examiner III

TRISTAR Insurance Group

. Manage all aspects of indemnity workers’ compensation claims from inception to conclusion within established authority and guidelines .

Posted 9/15/2026full-timeMilwaukee • Wisconsin • United StatesMid-LevelSenior💰 $70,000 - $85,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing indemnity workers' compensation claims, including complex cases, while adhering to statutory regulations and company guidelines. Proficient in communication and analytical skills to effectively resolve claims and interact with various stakeholders.

Highest-signal resume keywords

Workers' Compensation Claims ManagementStatutory Regulations KnowledgeAnalytical SkillsExcellent Written and Verbal CommunicationComplex Claims Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims InvestigationClaim Compensability DeterminationMedical Treatment ManagementMedical Billing AuthorizationReserve ComputationClaims SettlementFile ReviewDiary System Maintenance

Soft Skills

Interpersonal SkillsIndependent ManagementEffective Communication

Tools & Technologies

Microsoft WordMicrosoft Excel

Industry Keywords

Indemnity ClaimsClaims AdministrationLoss ControlInjury TrendsSafety Concerns

About the role

Key responsibilities & impact

Manage all aspects of indemnity workers’ compensation claims from inception to conclusion within established authority and guidelines
Manage a caseload of 150 or fewer workers’ compensation files, including complex claims
Initiate and investigate claims promptly
Determine claim compensability and administer benefits based on state law and company guidelines
Manage medical treatment and medical billing, authorizing as appropriate
Refer cases to outside defense counsel and direct/manage them as appropriate
Communicate with claimants, providers, and vendors regarding claims issues
Compute and set reserves within company guidelines
Settle and finalize claims and obtain designated authority
Maintain diary systems and document claim files
Communicate information to clients to resolve claims efficiently, including injury trends and safety concerns
Involve loss control staff when appropriate
Conduct file reviews independently
Adhere to company policies and procedures
Perform other duties as assigned

Requirements

What you’ll need

Bachelor’s degree in a related field preferred
Three (3) or more 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 conveying technical details to claimants, clients, and staff
Ability to interact with persons at all levels in the business environment
Ability to independently and effectively manage very complex claims
Proficient in Word and Excel preferred
High School Diploma or GED listed as the education level

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account TRISTAR Insurance Group Website LinkedIn All Job Openings 501 - 1000 employees Founded 1987 💼 Consulting 🏥 Healthcare 📦 Logistics Consulting
Healthcare
Logistics TRISTAR Insurance Group is a national third-party administrator (TPA) that provides insurance administration and risk management services to employers, insurers and public entities. Its solutions include property & casualty, workers' compensation, general and auto liability, managed care (bill review, case management, utilization review, nurse triage, pharmacy benefit management), absence and disability management, employee group benefits administration, and risk control and workplace safety services. TRISTAR emphasizes collaborative, technology-enabled and tailored services to transform risk into opportunity for its clients. Workers Compensation Claims Examiner III Job not on LinkedIn 🔥 51 minutes ago 🏢🏡 Milwaukee – Hybrid 💵 $70k - $85k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 📋 Claims Specialist 👻 Ghost score 0% Apply Now Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Manage all aspects of indemnity workers’ compensation claims from inception to conclusion within established authority and guidelines
Manage a caseload of 150 or fewer workers’ compensation files, including complex claims
Initiate and investigate claims promptly
Determine claim compensability and administer benefits based on state law and company guidelines
Manage medical treatment and medical billing, authorizing as appropriate
Refer cases to outside defense counsel and direct/manage them as appropriate
Communicate with claimants, providers, and vendors regarding claims issues
Compute and set reserves within company guidelines
Settle and finalize claims and obtain designated authority
Maintain diary systems and document claim files
Communicate information to clients to resolve claims efficiently, including injury trends and safety concerns
Involve loss control staff when appropriate
Conduct file reviews independently
Adhere to company policies and procedures
Perform other duties as assigned 🎯 Requirements
Bachelor’s degree in a related field preferred
Three (3) or more 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 conveying technical details to claimants, clients, and staff
Ability to interact with persons at all levels in the business environment
Ability to independently and effectively manage very complex claims
Proficient in Word and Excel preferred
High School Diploma or GED listed as the education level Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score View More Claims Specialist Jobs 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Remote jobs Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources About us Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Is Remote Rocketship legit? Privacy policy Terms of service Job board SEO course Remote Job Search MasterClass Resume Review AI Apply Copilot OpenClaw job finder API docs Find jobs using your resume Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs