Senior Claims Examiner
Senior Claims Examiner
St. Luke's Health System
Boise, ID
See who St. Luke's Health System has hired for this role
St. Luke’s Health System in Boise, ID is seeking a Sr. Claims Examiner to join our Workers Compensation team. This position is 100% remote, but must reside in Oregon or Idaho.
What You Can Expect
At St. Luke’s, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Virgin Pulse Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.
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.
What You Can Expect
- Very supportive team environment (9 team members).
- Work from home in Idaho 7:30am to 4:00pm with occasional on-site meetings in Boise.
- Manageable claim inventory (50-60 claims per adjuster).
- Self-insured and Self-administered program.
- Ability to meet in-person with claimants and their leaders.
- 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, 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.
- Education: Bachelor’s degree or experience in lieu of degree
- Experience: 4 years relevant experience
- Licenses/Certifications: Idaho Independent Adjuster's License
At St. Luke’s, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Virgin Pulse Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.
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.
- Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.
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Seniority level
Mid-Senior level -
Employment type
Full-time -
Job function
Finance and Sales -
Industries
Non-profit Organizations, Executive Offices, and Hospitals and Health Care
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