Senior Claims Examiner
Not Disclosed•Full-TimeHybrid
location_on18460, East Taft Avenue, Villa Park, Orange County, California, 92861, United States
About Athens Administrators
Since our founding in 1976, Athens Administrators has been a dynamic and innovative leader in claims administration. As a nationwide, family-owned company, we foster an engaging, supportive, and inclusive culture where employees not only thrive but consistently recognize us as a "Best Place to Work." We are dedicated to fair and equitable compensation that is competitive and reflective of the market, offering a comprehensive benefits package including medical, vision, dental, life insurance, and 401k options.
About the Role
We are seeking a Senior Claims Examiner to join our Workers' Compensation team in California. This role is pivotal in supporting our offices, with the flexibility to work remotely for most days, provided technical requirements are met and the employee resides in California. Employees living within 26 miles of our Concord or Orange offices are required to work in-office one day per week (Tuesday–Thursday).
In this position, you will guide workers' compensation claims from inception through settlement and closure. You will ensure the timely processing of claims and payment of benefits while managing and directing medical treatment, setting reserves, and negotiating settlements. Beyond handling individual cases, you will provide direction to Claims Assistants and Technicians, assisting with their training, coaching, and mentoring to support daily operations. You will serve as a trusted point of contact for employers, employees, attorneys, and medical providers, ensuring high-quality customer service and professional communication throughout the claims lifecycle.
Hiring Process
We look forward to learning about you! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply. Please submit your resume and application directly through our website at athensadmin.com. You may include a cover letter to share additional details. All applications are reviewed by our in-house Corporate Recruitment team.
Equal Opportunity & Culture
Athens Administrators is an Equal Opportunity/Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in all decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment.
We are committed to fair hiring practices and will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Our operations involve handling confidential, proprietary, and highly sensitive information, making honesty and integrity essential for every team member.
Work location
Work model: Hybrid
18460, East Taft Avenue, Villa Park, Orange County, California, 92861, United States
Villa Park, California
Key Responsibilities
- check_circleAdjust workers' compensation claims from inception through settlement and closure
- check_circleEstablish and maintain appropriate claim reserves
- check_circleReview legal correspondence and medical reports for appropriateness
- check_circleEvaluate and approve medical procedures and treatment plans
- check_circleMonitor and assist with litigation strategies and draft settlements
- check_circleDocument and code claim files and update action plans in the claims system
- check_circleRespond to inquiries from employers, employees, doctors, and attorneys
- check_circlePrepare and present professional reports to clients
- check_circleProvide direction, training, and mentoring to Claims Assistants and Technicians
- check_circleNegotiate settlements, liens, and rehabilitation plans
Requirements
- verifiedHigh School Diploma or equivalent (GED) required
- verifiedAA/AS or BA/BS preferred
- verifiedAdministrators Certificate from Self-Insurance Plans required within one year
- verifiedCurrent Experienced Indemnity Claims Adjuster Designation per California Code of Regulations
- verified3+ years recent workers compensation claims handling experience required
- verified5 years of workers compensation claims experience preferred
- verifiedSolid knowledge of workers compensation laws, policies, and procedures
- verifiedCompletion of IEA or equivalent courses
- verifiedProficiency in Microsoft Office Suite
Nice to Have
AA/AS or BA/BS degree. At least 5 years of workers compensation claims experience.
Benefits & Perks
check_circleMedical, Vision, Dental, Life, AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnitycheck_circleHSA and FSA options availablecheck_circle401k and Roth 401k retirement planscheck_circleCompany-Paid Short Term Disability (STD) and Long Term Disability (LTD)Discretionary salary adjustments and incentive payments
Similar Job Opportunities
Skills, education and keywords
Skills: Workers Compensation, Microsoft Office Suite, Indemnity Claims Adjuster Designation, Administrators Certificate, Iea.
Education: High School Diploma or equivalent (GED) required.
Frequently asked questions about Senior Claims Examiner at Athens Administrators
What does a Senior Claims Examiner at Athens Administrators do?expand_more
Day-to-day, the Senior Claims Examiner at Athens Administrators will adjust workers' compensation claims from inception through settlement and closure; establish and maintain appropriate claim reserves; review legal correspondence and medical reports for appropriateness; and evaluate and approve medical procedures and treatment plans.
What are the requirements for this Senior Claims Examiner role?expand_more
To qualify for the Senior Claims Examiner at Athens Administrators position, applicants should have: High School Diploma or equivalent (GED) required; AA/AS or BA/BS preferred; Administrators Certificate from Self-Insurance Plans required within one year; Current Experienced Indemnity Claims Adjuster Designation per California Code of Regulations; 3+ years recent workers compensation claims handling experience required; and 5 years of workers compensation claims experience preferred.
Where is the Senior Claims Examiner role at Athens Administrators located?expand_more
Senior Claims Examiner at Athens Administrators is based in 18460, East Taft Avenue, Villa Park, Orange County, California, 92861, United States. This is a hybrid role.
Is this Senior Claims Examiner job remote, hybrid, or on-site?expand_more
Athens Administrators has listed this Senior Claims Examiner role as hybrid.
How much experience is required for this Senior Claims Examiner role?expand_more
Senior Claims Examiner at Athens Administrators typically requires 3+ years of relevant experience at the senior level.
What skills do you need for the Senior Claims Examiner role at Athens Administrators?expand_more
Key skills for Senior Claims Examiner at Athens Administrators include Workers Compensation; Microsoft Office Suite; Indemnity Claims Adjuster Designation; Administrators Certificate; and Iea.
What education is required for Senior Claims Examiner at Athens Administrators?expand_more
Educational requirements for this role: High School Diploma or equivalent (GED) required.
What category does the Senior Claims Examiner role belong to?expand_more
Senior Claims Examiner at Athens Administrators is part of the admin job category on Recrutus.