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What is a worker's compensation claims examiner and how to become one
To avoid fraudulent claims, insurance companies hire workers' compensation claims examiners to analyze claims for validity. Aside from that, the main objective of their role is to ensure that workers are compensated fairly and in a timely manner.
The workflow of a workers' compensation claims examiner generally involves ensuring the accuracy of claim documents, reviewing information on the claim, determining the appropriateness or validity of the claim, and then authorizing payment to the claimant (or rejecting the claim).
To become a workers' compensation claims examiner, you would need at least a high school diploma, but a degree is the most common qualification for insurance companies. More than that, you would need to be knowledgeable in workers' compensation laws, HIPAA guidelines, and other relevant legislation to your industry.
On average, you can make around $82,000 per year as a workers' compensation claims examiner, depending on your level of education and prior work experience. To increase your income potential, it is ideal to have at least a bachelor's degree and around two years of experience in a relevant role.
Avg. Salary $53,581
Avg. Salary $59,228
Growth rate -6%
Growth rate 0.3%
American Indian and Alaska Native 0.50%
Asian 5.13%
Black or African American 10.70%
Hispanic or Latino 16.47%
Unknown 4.39%
White 62.81%
Genderfemale 75.00%
male 25.00%
Age - 43American Indian and Alaska Native 3.00%
Asian 7.00%
Black or African American 14.00%
Hispanic or Latino 19.00%
White 57.00%
Genderfemale 47.00%
male 53.00%
Age - 43Stress level is very high
7.1 - high
Complexity level is advanced
7 - challenging
Work life balance is poor
6.4 - fair
Worker's compensation claims examiner career paths
Key steps to become a worker's compensation claims examiner
Explore worker's compensation claims examiner education requirements
Start to develop specific worker's compensation claims examiner skills
Skills Percentages Rehabilitation 21.63% Social Security 16.40% Litigation 14.84% Medical Management 8.73% Workers Compensation Claims 8.73% Complete relevant worker's compensation claims examiner training and internships
Accountants spend an average of 1-2 years on post-employment, on-the-job training. New workers's compensation claims examiner learn the skills and techniques required for their job and employer during this time. The chart below shows how long it takes to gain competency as a worker's compensation claims examiner based on U.S. Bureau of Labor Statistics data and data from real worker's compensation claims examiner resumes.Research worker's compensation claims examiner duties and responsibilities
- Manage all aspects of claims, including heavy litigation and vocational rehabilitation cases.
- Negotiate settlements and actively manage the litigation process and process complex and technically difficult claims.
- Determine benefits when processing medical claims receive as HCFA and UB92 paper claims or electronically.
- Set up vehicle inspections, and rental reservations as a part of the claim settlement process.
Prepare your worker's compensation claims examiner resume
When your background is strong enough, you can start writing your worker's compensation claims examiner resume.
You can use Zippia's AI resume builder to make the resume writing process easier while also making sure that you include key information that hiring managers expect to see on a worker's compensation claims examiner resume. You'll find resume tips and examples of skills, responsibilities, and summaries, all provided by Zippi, your career sidekick.
Choose from 10+ customizable worker's compensation claims examiner resume templates
Build a professional worker's compensation claims examiner resume in minutes. Browse through our resume examples to identify the best way to word your resume. Then choose from 10+ resume templates to create your worker's compensation claims examiner resume.
Apply for worker's compensation claims examiner jobs
Now it's time to start searching for a worker's compensation claims examiner job. Consider the tips below for a successful job search:
- Browse job boards for relevant postings
- Consult your professional network
- Reach out to companies you're interested in working for directly
- Watch out for job scams
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Average worker's compensation claims examiner salary
The average worker's compensation claims examiner salary in the United States is $53,581 per year or $26 per hour. Worker's compensation claims examiner salaries range between $33,000 and $84,000 per year.
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Worker's compensation claims examiner reviews
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Updated January 8, 2025
