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Worker's compensation claims examiner skills for your resume and career
Updated January 8, 2025
3 min read
Below we've compiled a list of the most critical worker's compensation claims examiner skills. We ranked the top skills for workers's compensation claims examiner based on the percentage of resumes they appeared on. For example, 21.6% of worker's compensation claims examiner resumes contained rehabilitation as a skill. Continue reading to find out what skills a worker's compensation claims examiner needs to be successful in the workplace.
15 worker's compensation claims examiner skills for your resume and career
1. Rehabilitation
Here's how workers's compensation claims examiner use rehabilitation:
- Attended rehabilitation conferences before the Rehabilitation Bureau and participated in informal conferences via telephone conference calls.
- Coordinate case management with the Managed Care Director and the Rehabilitation Coordinator.
3. Litigation
Here's how workers's compensation claims examiner use litigation:
- Worked collaboratively with attorneys to draft settlements and assisted with litigation strategies.
- Litigated claims for litigation cost containment and settlements.
4. Medical Management
Medical management helps navigate all facets of health care to improve the quality and outcomes of health care delivery for health, disease, nursing, and case management functions. The goal of medical management is to improve the delivery of all medications, improve patient use, reduce side effects and interactions of drugs, and provide peace of mind to patients as they can be confident that medications are being taken correctly.
Here's how workers's compensation claims examiner use medical management:
- Coordinate medical management of claims.
- Negotiate case settlements and determine need for medical management and long term care.
5. Workers Compensation Claims
Here's how workers's compensation claims examiner use workers compensation claims:
- Investigated and serviced workers compensation claims in adherence to Minnesota law.
- Completed intensive Workers Compensation Claims handling to achieve California Certification.
6. TPA
Here's how workers's compensation claims examiner use tpa:
- Acted as TPA and managed a very large caseload of 450 - 500 claims that were once Reliance claims.
- Participated in numerous TPA claim reviews with carriers, insured and brokers/Claim Account Managers.
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Here's how workers's compensation claims examiner use medical treatment:
- Prepared case files and arranged for second opinion and independent medical examinations when necessary to establish compensation or medical treatments.
- Provided analysis of AOE/COE determinations, authorizations of medical treatment, recommendations for settlements and rating of Permanent Disability cases.
8. Medical Reports
Here's how workers's compensation claims examiner use medical reports:
- Reviewed various medical reports and personal statements to ascertain causal relationships and whether injury was in performance of duty.
- Evaluated medical reports and discussed claim information program requirements with injured worker or claimants.
9. Claims Resolution
Here's how workers's compensation claims examiner use claims resolution:
- Develop and managing claims resolution.
- Maintain contact with the employees, provide information, explain benefits and coordinate claims resolution.
10. Compensation Benefits
Here's how workers's compensation claims examiner use compensation benefits:
- Developed and maintained solid relationships with external and internal customers/ vendors which included presentations to accounts on Workers Compensation benefits.
- Process payments of workers compensation benefits including indemnity payments to injured workers and medical bill payments to medical providers.
11. Medical Benefits
Here's how workers's compensation claims examiner use medical benefits:
- Determine benefit eligibility and provide indemnity and medical benefits within the time frames specified in state Labor Codes.
- Calculate and issue indemnity and medical benefits from claim inception to settlement/resolution.
12. Insurance Carriers
Here's how workers's compensation claims examiner use insurance carriers:
- Updated files with the Division of Insurance Carriers and Self-Insurance Fund.
- Maintain contact with the liquidator, Division of Workers Compensation, legal representatives and reporting to excess/reinsurance carriers.
13. Claims Handling
Here's how workers's compensation claims examiner use claims handling:
- Supervised and educated administrative staff and claims assistants regarding day to day support and claims handling requirements.
- Represented clients/employers interests to minimize costs by effective claims handling.
14. Death Claims
Here's how workers's compensation claims examiner use death claims:
- Examined, investigated, evaluated, developed, and adjudicated claims of compensation for full range of disability and death claims.
- Examined, developed, processed, and adjudicated disability and death claims.
15. Vendor Referrals
Here's how workers's compensation claims examiner use vendor referrals:
- Coordinate with vendor referrals for additional investigation.
- Coordinate vendor referrals and use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for clients.
5 Worker's Compensation Claims Examiner resume examples
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List of worker's compensation claims examiner skills to add to your resume
The most important skills for a worker's compensation claims examiner resume and required skills for a worker's compensation claims examiner to have include:
- Rehabilitation
- Social Security
- Litigation
- Medical Management
- Workers Compensation Claims
- TPA
- Medical Treatment
- Medical Reports
- Claims Resolution
- Compensation Benefits
- Medical Benefits
- Insurance Carriers
- Claims Handling
- Death Claims
- Vendor Referrals
- State Agencies
- Permanent Disability
- Financial Exposure
- Medical Evidence
- Vocational Rehabilitation
- Medical Claims
- Medical Bills
- Compensation ACT
- Defense Counsel
- Medical Documentation
- Compensation Board
- Indemnity Claims
- Statutory Limits
- EDI
- State Filings
- NYS
- Compensation Laws
- Medical Care
- Settlement Negotiations
- Professional Client Relationships
- State Forms
- Benefit Notices
- TTD
- Defense Attorneys
- Resolves Claims
- Telephone Calls
- Indemnity Payments
- Diary Management
- Disability Benefits
- CPT
- Medical Facilities
- Claims Reviews
Updated January 8, 2025
Updated January 8, 2025
2. Social Security
Social security is a federal government program that offers benefits to those registered under it when they are retired or can't work because of some sort of disabilities.