Workers Compensation Claims Examiner- Remote (TX)
- Houston, United States
Posted 24 days ago
About the role
Senior Workers’ Compensation Claims Adjuster – Texas
Location: Houston, TX
Job Type: Full-Time, Direct Hire
Salary: Up to $88,000/year
Caseload: Approximately 110–150 Workers’ Compensation Files
****THIS IS NOT A MEDICAL BILLING POSITION****
*****ONLY APPLY IF YOU HAVE WORKERS COMP CLAIMS EXPERIENCE*****
****MUST HAVE A WORKERS COMP LICENSE*****
Are you an experienced Texas Workers’ Compensation Claims Adjuster who can independently manage complex indemnity claims from first notice of loss through resolution?
We are hiring a Senior Workers’ Compensation Claims Adjuster to join an established national third-party administrator (TPA) in Houston. This is a senior-level individual contributor position for an adjuster who understands Texas workers’ compensation regulations, can confidently make compensability decisions, and is comfortable taking ownership of a complex caseload.
If you have 5+ years of workers’ compensation claims experience, strong indemnity experience, and an active Texas Workers’ Compensation Adjuster License, we want to hear from you.
What You’ll Be Doing
Independently manage approximately 110–150 workers’ compensation files, including complex and high-exposure indemnity claims.
Handle claims from initial report through final resolution.
Conduct timely and thorough claim investigations.
Determine compensability in accordance with Texas workers’ compensation laws and regulations.
Administer appropriate workers’ compensation benefits.
Manage medical treatment, authorizations, and medical billing.
Evaluate claim exposure and establish appropriate reserves within assigned authority.
Maintain an organized diary system and ensure files accurately reflect claim activity and status.
Communicate regularly with injured workers, medical providers, vendors, clients, and other stakeholders.
Provide clients with timely updates regarding claim status, injury trends, and safety concerns.
Conduct independent file reviews.
Identify issues that could affect claim exposure and take appropriate action.
Maintain compliance with company policies, procedures, and regulatory requirements.
Drive claims toward timely and appropriate resolution.
What You Must Have
Active Texas Workers’ Compensation Adjuster License – REQUIRED
Minimum 5 years of workers’ compensation claims handling experience.
Strong indemnity claims experience – REQUIRED.
Demonstrated experience independently handling complex workers’ compensation claims.
Strong knowledge of Texas workers’ compensation statutes and regulations.
Experience with claim investigation, compensability, medical management, reserves, and claim resolution.
Strong knowledge of medical terminology.
Excellent analytical and investigative skills.
Strong written and verbal communication skills.
Ability to independently manage a high-volume caseload.
High School Diploma or GED.
Candidates without an active Texas Workers’ Compensation Adjuster License will not be considered for this position.
Preferred Qualifications
Bachelor's degree in a related field.
Previous TPA or multi-client claims experience.
Experience managing approximately 110–150 workers’ compensation files.
Experience handling complex or high-exposure indemnity claims.
Proficiency with Microsoft Word and Excel.
Why Consider This Opportunity?
Join an established national claims organization with more than 30 years of experience providing workers’ compensation, claims management, loss control, and risk management services.
This position offers experienced adjusters the opportunity to take ownership of a meaningful caseload, work with complex claims, and continue developing their technical expertise within a professional claims environment.
If you have an active Texas Workers’ Compensation Adjuster License, 5+ years of WC claims experience, and a strong indemnity background, apply today for immediate consideration.
Email your resume today!
mpalkin@teemagroup.com
#Workwolf