Bankers Surety ยท 2 months ago
Workers Compensation Claims Examiner II
St. Petersburg, FL, US
Full-time
Onsite
Mid, Senior Level
3+ years expDecisionHR is a Professional Employer Organization (PEO) located in St Petersburg, FL. The Workers Compensation Claims Examiner II is responsible for managing complex workers' compensation claims, ensuring strategic resolution and optimal cost management while serving as a consultative resource for clients and stakeholders.
Financial ServicesInformation TechnologySecurity
Responsibilities
Serve as the lead consultant for high-exposure, litigated, and complex claims that exceed examiner authority. Manages a book of high-exposure claims (> $100K in open reserves)
Analyze coverage, liability, and damages to recommend optimal settlement strategies
Work closely with defense counsel, adjusters, DHR Claims Examiners, and third-party administrators (TPAs) to mitigate risk
Provide expert recommendations on reserving strategies to ensure financial accuracy
Consult with internal teams and clients to optimize employer-level claim investigations and mitigation strategies
Communicate concise, data-driven insights to clients, ensuring clarity in claim development and financial impact
Serve as a liaison between claims adjusters, risk management, and loss prevention teams to facilitate improved outcomes
Conduct monthly and quarterly trend analysis to identify emerging risks, cost drivers, and loss trends
Utilize industry benchmarks and analytics tools to develop data-driven claims strategies
Contribute to organizational risk management efforts by presenting actionable insights to senior leadership
Assist in standardizing claims documentation, reporting, and tracking methodologies
Provide mentorship and subject-matter expertise to claims examiners while ensuring best practices in claims handling
Qualification
Required
3 to 5 years of experience in multi-state workers' compensation claims management with a PEO, insurance carrier, or brokerage
Strong expertise in claims litigation, financial reserving, medical management, and return-to-work programs
Proven ability to synthesize claims data into strategic risk management insights
Strategic thinker with the ability to balance thorough investigation with efficient execution
Strong interpersonal skills to build relationships with claims adjusters, defense counsel, and client companies
Preferred
Bachelor's degree in risk management, business, or related field
Advanced claims certifications (e.g., AIC, ARM, CPCU) preferred
Company
Bankers Surety
Florida based financial security company.
501-1000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase