[Hiring] Medical Only Examiner @Gallagher

Role Description

Keenan, now a part of Gallagher, is seeking a detail-oriented and customer-focused Medical Only Claims Examiner to join our Workers' Compensation Claims team. In this role, you will be responsible for administering Medical Only workers' compensation claims, ensuring timely claim processing, accurate benefit administration, regulatory compliance, and outstanding service to clients and injured workers.

This is an excellent opportunity for a claims professional who values accuracy, organization, and providing exceptional support throughout the claims process.

How you'll make an impact

• Process and administer Medical Only workers' compensation claims in accordance with company policies and procedures.
• Perform data entry and establish all new Medical Only claims.
• Conduct claim investigations, including three-point contact when necessary, to verify injury details, compensability, and claim status.
• Review and process DWC notices, correspondence, and required documentation.
• Calculate and issue mileage reimbursements and other applicable benefits.
• Verify lost time, waiting periods, and eligibility requirements.
• Monitor and manage modified duty programs.
• Maintain accurate claim notes and timely diary management.
• Identify claims requiring escalation or conversion to Indemnity status and provide supporting documentation.
• Refer diagnostic services and imaging requests for utilization review as required.
• Process medical bills promptly to ensure compliance and avoid penalties or interest charges.
• Review reserve levels and update financial exposure as claim information changes.
• Investigate questionable claim circumstances and escalate concerns when appropriate.
• Maintain excellent claim closure performance and quality standards.
• Return phone calls and respond to inquiries within established service standards.
• Review incoming mail and electronic documents daily in a paperless environment.
• Correct system exception reports and maintain accurate claim records.
• Deliver exceptional service and maintain positive client and claimant relationships.
• Perform other duties as assigned.

Qualifications

• Required: Bachelor's degree and a minimum of 3 years claim handling experience in a brokerage firm or insurance industry.
• Preferred: California IEA class course completion.

Requirements

• Ability to multitask, communicate effectively, in writing and verbally, within all aspects of job requirements.

Benefits

• Competitive compensation.
• Comprehensive benefits programs designed to support your well-being.
• Career development opportunities and ongoing learning.
• A collaborative, people-first culture with accessible leadership.
• The opportunity to do meaningful work with global reach and local impact.