Claims Examiner (Workers' Comp)

About the role

CACI is seeking a detail-oriented, proactive Claims Examiner in Chantilly to manage and review workers' compensation claims. The role covers investigating and processing claims, negotiating settlements and keeping accurate records. It is a regular, full-time position requiring a TS/SCI clearance with polygraph.

Key responsibilities

• Analyze and process complex claims through action plans, gathering information to determine exposure
• Evaluate claims for coverage, compensability, liability and benefits owed
• Review medical, employment and other records to assess claims
• Handle settlements, reviews and negotiations fairly and ethically
• Communicate with injured employees, employers, medical providers, attorneys and internal stakeholders
• Authorize treatment and payments within authority limits, complying with policies and state laws
• Prepare reports on claim activity, reserve adequacy and resolution strategies
• Evaluate ongoing medical treatment plans and help arrange return-to-work options
• Collaborate with legal teams on litigation and disputes, and oversee case development including medical exams and referrals
• Maintain accurate claim records and meet federal workers' compensation deadlines
• Balance competing priorities in a limited-staff environment

Required profile

• Bachelor's degree and 3+ years of experience, or equivalent combination of education and 5+ years of relevant experience
• Ability to work independently and in a team, with strong written and verbal communication
• Strong organizational skills, attention to detail, negotiation and problem-solving abilities
• Proven ability to keep sensitive information confidential and extensive customer service experience
• Proficiency in Microsoft Office Suite or similar productivity software

Desired

• Knowledge of quantitative and qualitative research methods
• Understanding of Intelligence Community mission and business processes
• Experience supporting customer service across organizational elements
• Able to independently initiate, manage, execute and report government tasks

What we offer

• Proposed pay range of $70,800 - $148,600, depending on location, contract category, experience and skills
• Healthcare, wellness, financial, retirement, family support, continuing education and time-off benefits
• Flexible time off and learning resources