Self-Insured Workers Compensation Examiner

Sheakley is seeking an experienced Self-Insured Workers' Compensation Examiner to join our growing team. This position is responsible for the management of Ohio self-insured workers' compensation claims from inception through resolution. The ideal candidate will have strong Ohio workers' compensation knowledge, excellent customer service skills, and the ability to effectively manage a caseload while delivering exceptional claim outcomes for our clients.

Primary Responsibilities

• Investigate and manage Ohio self-insured workers' compensation claims.
• Determine compensability and administer claims in accordance with Ohio workers' compensation laws and regulations.
• Coordinate medical treatment and return-to-work strategies.
• Review medical records, treatment plans, and disability documentation.
• Communicate regularly with injured workers, employers, healthcare providers, attorneys, and BWC representatives.
• Monitor claim reserves and exposure.
• Attend hearings and prepare claim documentation as needed.
• Identify opportunities for claim resolution and cost containment.
• Develop and maintain positive client relationships through proactive claim management and communication.
• Maintain accurate and timely claim documentation within the claims management system.
• Collaborate with account managers, nurse case managers, and other internal resources to achieve optimal claim outcomes.

Qualifications

Required

• Minimum of 2 years of Ohio Workers' Compensation claims handling experience.
• Prior experience managing self-insured or Ohio BWC claims.
• Strong working knowledge of Ohio workers' compensation statutes, rules, and claims processes.
• Experience reviewing medical records and managing lost-time claims.
• Excellent verbal and written communication skills.
• Strong organizational and time management abilities.
• Ability to prioritize competing demands and effectively manage a caseload.
• Proficiency with Microsoft Office applications and claims management systems.

Preferred

• Ohio Self-Insured claim handling experience.
• Third-Party Administrator (TPA) experience.

This job description is not intended to be all inclusive and the employee will also perform other reasonably related business duties as assigned by the immediate supervisor and other management as required.