Job description
Workers’ Compensation Claims Adjuster
Job Summary
Seeking an experienced and detail-oriented Workers’ Compensation Claims Adjuster to manage indemnity claims from initial report through resolution. This role requires a strong understanding of workers’ compensation laws and regulations, the ability to evaluate complex claims, and a commitment to timely, compliant, and customer-focused claim handling. Responsibilities include investigation, documentation, collaboration with vendors and medical partners, and proactive claim resolution.
Responsibilities
- Conduct three-point contact on all new losses within required timeframes, including outreach to the claimant, employer, and treating physician
- Investigate claims thoroughly to establish compensability, disability status, and treatment plans
- Maintain accurate and timely documentation of all claim activity, medical updates, and expense payments
- Develop and maintain an up-to-date action plan for each assigned indemnity claim to drive timely resolution
- Partner with medical case management to support early return-to-work initiatives and minimize extended disability exposure
- Coordinate the use of vendors as needed to support claim investigation and resolution
- Identify and refer suspected fraudulent claims to the appropriate special investigations unit
- Ensure compliance with applicable workers’ compensation laws, regulations, and internal guidelines
Compensation Package
- Base salary range: $80,000 – $98,000 annually (depending on experience)
- Competitive benefits package, paid time off, professional development opportunities, etc.
Qualifications / Requirements
- 3 – 5+ years of workers’ compensation claims handling experience
- Demonstrated experience managing indemnity claims
- Familiarity with applicable workers’ compensation regulations and procedures
- Experience with 4850 claims handling or SIP exposure
- Strong organizational, analytical, and communication skills
Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer’s discretion.
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