Claims Examiner III (Hybrid)

Hybrid Claims Examiner III role focused on managing complex and litigated indemnity claims from inception to conclusion under supervision. Responsibilities include investigating claims, determining compensability, administering benefits per state law and company practices, managing medical treatment and billing, referring cases to outside defense counsel, coordinating with claimants, attorneys, providers and vendors, maintaining case diaries and action plans, computing and setting reserves, settling claims, mentoring less experienced Examiners, and supporting state audits. Requires strong analytical, written and verbal communication skills, proficiency with Word and Excel, and the ability to handle very complex claims across multiple jurisdictions.