St. Luke's Health System

At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work.

Remote work can be supported in Idaho only, per Idaho adjuster rules.

The Sr. Claims Examiner is responsible for the investigation and administration of St. Luke’s Health System Employee workers’ compensation claims.
 
What You’ll Do:
 * Lead complex claim management - Oversee a portfolio of workers’ compensation claims, including sophisticated occupational disease cases requiring in-depth analysis of pre-existing medical conditions, environmental exposures, and causation.
 * Drive compensability decisions - Conduct comprehensive investigations, leveraging policy interpretation, regulatory research, court rulings, and collaboration with employees, medical providers, employers, and legal counsel to make well-supported determinations.
 * Own financial stewardship - Establish and proactively manage claim reserves, ensuring accurate forecasting and responsible cost management.
 * Deliver exceptional case oversight - Maintain current, well-documented claim files through consistent communication and proactive follow-up with all stakeholders.
 * Ensure accurate benefit administration - Calculate and issue time-loss and impairment benefits, file required state documentation in compliance with Idaho Workers’ Compensation Law, and authorize appropriate medical payments.
 * Influence settlement strategy - Analyze exposure and provide thoughtful recommendations on lump sum settlements; negotiate settlements within delegated authority and in partnership with leadership.
 * Maximize recovery opportunities - Identify and pursue third-party recovery opportunities to mitigate claim costs when applicable.
 * Contribute to workplace safety insights - Partner with the Safety Officer to identify trends, serious injuries, and occupational disease patterns, helping drive preventative and corrective measures.
 
Qualifications:
 * Bachelor's Degree or experience in lieu of 
 * 4 years' relevant experience
 * 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 Personify Health 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.