Senior Claims Examiner

Category
Human Resources
Department
6913-WORKERS COMPENSATION
Position Type
Regular Full-Time
Work Schedule
DAY
Boise
Requisition ID
2017-9192

Overview

 

St. Luke’s Health System has an exciting opportunity for a Sr. Claims Examiner to join our team! The Sr. Claims Examiner is responsible for the investigation and administration of St. Luke’s Health System Employee workers’ compensation claims.

 

-       Responsible for workers’ comp claims caseload, including more complicated occupational disease claims which require a higher level of experience and knowledge to determine pre-existing medical conditions, what environmental exposures exist, and determination of causation.

-        Verifies compensability through research of the appropriate policies, regulations, court rulings, and contact with employees, medical providers, employer, and legal counsel.

 

-        Establishes and maintains adequate reserves to cover the estimated cost of claims.

 

-        Maintains all assigned claims files in current condition through contact with employer, employees and medical providers.

 

-        Calculates and pays all time loss and impairment benefits for worker’s compensation claims; files state forms on a timely basis in accordance with the Idaho Workers’ Compensation Law.

 

-        Reviews and authorizes payment of all medical benefits for worker’s compensation claims.

 

-        Analyzes and makes recommendations regarding lump sum settlements. Under direction from leadership, negotiates lump sum settlements within approved authority.

-       Investigates and seeks third party recovery on claims whenever appropriate.

-       Coordinates with Safety Officer in identifying any trends, serious injuries or occupational diseases and potential corrective measures.

-       Assists with supervision of human and environmental resources.

-       Performs other duties and responsibilities as assigned.

 

       

 Required Criteria 

  • Bachelor’s Degree or 4 years of additional work experience in lieu of degree
  • 4 years of experience

 

Required Licensure 

  • Independent Adjuster’s Licence

 

Preferred Criteria

  • Previous experience in workers compensation insurance industry preferably as a Claims Adjuster, Claims Analyst, or Claims Examiner with full knowledge of investigation and administration of claims typically gained through six plus years of direct experience.

 

 

Our employees enjoy many benefits, some of the most popular are tuition reimbursement, hospital retirement contributions, and hospital-supported on-going training and education.

 

If you’re looking for a place where you can grow in your personal life, in your career, and in your community, St. Luke’s may be just the place for you.

 

A strong, talented staff is at the heart of St. Luke’s Health System. We are the state’s largest employer with more than 13,500 employees and a medical staff of more than 1,800 physicians and advanced practice clinicians. Our employees are dedicated to impacting the lives of those in our community while pursuing a life- changing career at St. Luke’s. Our staff is the reason for our outstanding reputation as both a quality employer and superior healthcare organization. We’re proud of our people who deliver skilled, compassionate care every day, and are looking to add dedicated individuals who will continue in the same tradition of excellence.

 

With multiple locations in the beautiful southern and central Idaho, our mild, four season climate means you can play outdoors year-round. Whether you prefer leisurely walks along the river or heart-pounding climbs up a sheer cliff- there is always something to do after work. An exciting mix of urban and outdoor life defines Idaho’s culture, you can ski in the morning and watch a college sporting event at night. It is a great state to raise a family and forge lasting relationships. The cost of living is low, and quality of life is high.

 

__________________ 

 

#One of American’s Top 15 Health Systems - U.S.News & World Report, "America's Best Hospitals 2015-2016" 

 

*St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.

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