Workers’ Compensation Claims Examiner III

Job overview

The Workers’ Compensation Claims Examiner III role is in-office in Kapolei, HI, with compensation of $85,000–$95,000 per year. The examiner works under the direction of a Claims Supervisor or Claims Manager and manages workers’ compensation claims through resolution. The role supports timely, compliant, and cost-effective claim outcomes by investigating claims, determining compensability, coordinating medical care, setting reserves, and developing resolution strategies. Senior-level work includes complex and litigated claims, client reporting, and technical guidance to less experienced examiners.

What you'll do

• Manage a caseload of complex workers’ compensation claims
• investigate claims and document findings
• determine compensability and administer benefits under applicable laws and guidelines
• manage medical treatment and billing
• set reserves
• maintain claim files and action plans
• settle or finalize claims with appropriate authority
• conduct file reviews
• manage complex and litigated claims, litigation strategy, reporting, and mentoring responsibilities.

What we're looking for

Skills & competencies

workers’ compensation

claims examiner iii

claims management

complex claims

litigated claims

kapolei hi

teemagroup

$85k–$95k/year

claim investigation

medical claims

settlement strategy

Work arrangement

• Weekend coverage required

Why this role

Senior-level responsibilities include catastrophic and litigated indemnity claims, litigation strategy, regulatory reporting, and mentoring.

About the employer

TeemaGroup is hiring for this role. Industry: Claims Adjusting. Sector: 52.