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Sr. WC Claims Examiner jobs in United States
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Acrisure · 18 hours ago

Sr. WC Claims Examiner

Acrisure is a company dedicated to building a community where individuals can grow and thrive. They are seeking a Sr. Claims Examiner responsible for managing workers’ compensation claims, investigating claims, and communicating with various stakeholders to ensure timely resolutions.
Financial ServicesInsuranceInsurTech

Responsibilities

Interviews, telephones, or corresponds with claimant and witnesses, consults police and hospital records
Contacts physicians to obtain medical diagnoses and projected treatment plans
Monitors medical progress of claimants and coordinates follow-up treatments; reports to employers including any restrictions that may be imposed on claimants’ return to work
Documents all information from contacts with employers, claimants, physicians, and attorneys into the claims’ management system and ensures that documentation is current
Calculates and sets reserves through a reserve worksheet including the nature and scope of claims; adjusts reserves to reflect ultimate known exposures
Issues medical, indemnity, legal and expense payments
Prepares reports for excess carriers and requests reimbursement when needed
Sets reminders to follow-up on tasks through diaries on the system; reviews and completes diaries daily
Maintains physical files for claim-related documents such as medical information, legal reports, and other correspondence
Reviews claims’ submissions for thoroughness and accuracy
Determines compensability of claims through information gathered and according to workers’ compensation statutes; makes recommendations as to compensability and coverage of claims
Provides guidance and advice to clients on direction of claims after all information has been gathered and analyzed
Ensures jurisdictional filings are complete and timely
Obtains pre-certification approval for specific treatments as needed
Reviews bills and medical notes; authorizes and codes bills
Attends seminars and meetings as needed to stay abreast of current industry knowledge
May attend mediations, hearings, trials, or other legal proceedings

Qualification

Workers' compensation claimsClaims management systemActive licensingMulti-line experienceBilingual (Spanish)Computer skillsOrganizational skillsCommunication skillsAttention to detailCustomer focused

Required

High School diploma or equivalent (required)
Minimum of Five (5) years' experience handling complex workers' compensation lost-time claims
Multi-line experience (required)
Experienced Workers Comp Claim Adjuster / with active licensing
Strong organizational skills, attention to details and the ability to multi-task and prioritize works
Strong verbal, presentation, and written communication skills
Strong computer skills including proficiency in Microsoft Word, Excel and Outlook
Self-motivated and customer focused
Attention to details and accuracy in documentation. Maintain detailed and accurate records of claims
Ability to establish and maintain good working relationships and rapport with others

Preferred

Bilingual (Spanish) a plus

Benefits

Comprehensive medical insurance
Dental insurance
Vision insurance
Life and disability insurance
Fertility benefits
Wellness resources
Paid sick time
Generous paid time off and holidays
Employee Assistance Program (EAP)
A complimentary Calm app subscription
Immediate vesting in a 401(k) plan
Health Savings Account (HSA) and Flexible Spending Account (FSA) options
Commuter benefits
Employee discount programs
Paid maternity leave
Paid paternity leave (including for adoptive parents)
Legal plan options
Pet insurance coverage

Company

Acrisure

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Acrisure offers financial services solutions for insurance, reinsurance, real estate, cyber services, and asset and wealth management.

Funding

Current Stage
Late Stage
Total Funding
$11.37B
Key Investors
Bain Capital Special SituationsAbu Dhabi Investment AuthorityBDT & MSD Partners
2025-06-06Debt Financing· $550M
2025-05-20Private Equity· $2.1B
2024-06-05Debt Financing· $1.6B

Leadership Team

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Greg Williams
Co-Founder, Chairman & CEO
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Mark Wassersug
Chief Technology Officer
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Company data provided by crunchbase