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Workers’ Compensation Claims Examiner

Location: Washington, DC / DMV Area

Employment Type: Contract

Industry: Government / Public Sector

NRI Staffing is seeking an experienced Workers’ Compensation Claims Examiner to support an upcoming government contracting opportunity.

The ideal candidate will have strong experience handling workers’ compensation claims from initial investigation through resolution, including reviewing medical documentation, determining compensability, establishing reserves, managing ongoing cases, and participating in hearings or settlement discussions.

Key Responsibilities

• Review, investigate, and adjudicate workers’ compensation claims.
• Analyze medical records, treatment plans, and supporting documentation to make claim determinations.
• Establish and maintain appropriate claim reserves.
• Manage claims throughout the full lifecycle and ensure timely case resolution.
• Apply applicable workers’ compensation laws, regulations, policies, and procedures.
• Participate in hearings, mediations, settlement conferences, and other claim-related proceedings as needed.
• Maintain accurate and confidential claim documentation.
• Communicate with claimants, medical providers, attorneys, employers, and other stakeholders.

Qualifications

• Bachelor’s degree plus at least 2 years of workers’ compensation claims adjusting experience, OR
• At least 8 years of progressively responsible claims-handling experience, including a minimum of 3 years of workers’ compensation claims adjusting experience.
• Strong knowledge of workers’ compensation laws, regulations, investigations, reserving, case management, and claim adjudication.
• Experience analyzing medical evidence and making claim determinations.
• Experience participating in hearings, mediations, or settlement conferences.
• Knowledge of medical terminology and treatment review.
• Strong written and verbal communication skills.
• Proficiency with Microsoft Office and claims management systems.
• Ability to handle confidential and sensitive information with discretion.