# Workers’ Compensation Claims Examiner

**Company:** [Greenlife Healthcare Staffing](http://jobs.workable.com/companies/g5tX1mk2ZWTbffdtzNbnfV.md)
**Location:** Washington, United States
**Workplace:** on site
**Employment type:** Temporary
**Department:** Joseph Agha

[Apply for this job](http://jobs.workable.com/view/a9d10c2f-f276-49ae-bbc6-5a4d7e5e7dbd)

## Description

**Workers' Compensation Claims Examiner - Washington, DC (#R10291)**

-   _**Location: Washington, DC 20001**_
-   _**Employment Type: Temporary / Full-Time**_
-   _**Hourly Rate: $42 per hour**_

**About Greenlife Healthcare Staffing:**

Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals.

**Position Overview:**

Administers workers’ compensation claims from initial report through closure by investigating compensability, analyzing medical and employment evidence, making claim recommendations, coordinating services, maintaining claim records, and supporting hearings and settlements.

**Why Join Us?**

-   **Competitive Compensation:** Earn $42 per hour providing essential claims examination services for the Public Sector Workers' Compensation Program.
-   **Comprehensive Benefits:** Temporary, full-time position. No work on District holidays or administrative closure days.
-   **Work Schedule:** Full-Time (FTE), Monday-Friday, 8:30 a.m. - 5:00 p.m. ET; up to 40 hours per week. No work on District holidays or administrative closure days.
-   **Professional Growth:** Gain valuable experience in a collaborative, innovative, and supportive environment within a government office setting.
-   **Impactful Work:** Contribute to a mission-driven organization dedicated to improving outcomes for injured workers through professional claims administration and case management.

**JOB DESCRIPTION:**

-   Receive, review, and process first reports of injury, notices of loss, and workers’ compensation claims under applicable laws, regulations, policies, and procedures.
-   Investigate and evaluate claims to determine compensability and entitlement to medical and related benefits.
-   Manage medical-only workers’ compensation claims from inception through closure.
-   Collect and analyze medical records, employment records, witness statements, treatment plans, bills, and other claim evidence.
-   Review medical evidence for treatment appropriateness, medical necessity, work restrictions, and return-to-work opportunities.
-   Complete required claim contacts, including 24-hour four-point contacts with injured workers, supervisors, medical providers, and other stakeholders; document activity in the claims management system.
-   Develop factual findings, claim analyses, and recommendations supporting determinations and benefit decisions.
-   Coordinate with injured workers, agency representatives, healthcare providers, legal counsel, nurse case managers, and other stakeholders.
-   Coordinate medical appointments, independent medical evaluations, transportation services, and medically necessary follow-up care.
-   Assess maximum medical improvement, work capacity, and ongoing treatment needs using medical evidence and provider recommendations.
-   Draft notices, correspondence, claim determinations, and adjudication documents.
-   Maintain complete and timely claim files; research claim histories, laws, regulations, policies, and procedures.
-   Manage assigned caseloads to meet performance standards, statutory requirements, and customer-service expectations.
-   Participate in claim reviews, settlement discussions, mediations, hearings, and administrative proceedings; provide testimony or supporting documents when required.
-   Protect confidential medical, financial, and employment information and provide professional customer service.
-   Perform other related duties supporting the Public Sector Workers’ Compensation Program.

_**Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives**_

## Requirements

**Qualifications:**

-   **Job Qualifications & Certifications:**

-   Bachelor’s degree and at least two years of workers’ compensation claims adjusting experience; or eight years of progressively responsible claims-handling experience, including at least three years of workers’ compensation claims adjusting experience.
-   Knowledge of workers’ compensation laws, regulations, investigations, reserving, case management, and claim adjudication.
-   Ability to analyze medical evidence and make claim determinations.
-   Experience participating in hearings, mediations, or settlement conferences.
-   Knowledge of medical terminology and treatment review.

-   **Skills:**

-   Workers’ compensation investigation, compensability analysis, reserving, adjudication, and caseload management.
-   Medical and claim-record analysis, factual findings, and written determinations.
-   Claims management systems and Microsoft Office applications.
-   Stakeholder coordination, hearings and mediation support, customer service, and written and verbal communication.
-   Confidential and sensitive information handling.