Associate Workers' Compensation Claims Adjuster

About the role

ProService Hawaii is seeking an Associate Workers’ Compensation Claims Adjuster to join our Claims & Compliance team. In this role you’ll manage a high-volume portfolio of medical-only claims from first report through closure — ensuring regulatory compliance, accurate reserving, timely medical management, and a professional experience for both employers and injured workers. This role sits at the intersection of legal compliance, medical oversight, and client service. What makes it challenging — and rewarding — is that success requires disciplined execution across all three simultaneously, at volume, without missing a deadline.

This is a high-volume, process-driven, deadline-critical role where precision and documentation are non-negotiable. You’ll be managing 110–130 active medical-only claims at any given time—each with its own statutory timeline, reserve adequacy requirement, and client expectation. The work is structured by design, and performance is tracked closely. You own your caseload, your diary, and your files. We expect adjusters who stay ahead of their files, not behind them.

Responsibilities

• Investigate and manage medical-only workers’ compensation claims end-to-end, including three-point contact, compensability determinations, reserving, and action plan execution
• Establish and maintain accurate claim reserves within 48 hours of assignment and ensure timely, accurate medical bill review and payment
• Apply evidence-based treatment guidelines (e.g., ODG) to evaluate medical care, address unsupported treatment, and proactively mitigate risk of claim escalation to indemnity status
• Maintain strict diary management and meet all regulatory deadlines, ensuring audit-ready files and zero missed compliance requirements
• Provide clear, professional communication to clients and injured workers—setting expectations early and escalating complex exposures to senior adjusters appropriately
• Identify red flags such as lost time exposure, attorney involvement, or treatment complexity, and partner with senior adjusters to transition files when appropriate

Requirements

• Prior workers’ compensation experience is required
• A valid Hawaii WC Adjuster license in good standing is preferred; support provided for obtaining proper licensing
• Experience managing a high-volume WC caseload combined with tight deadlines and diary management
• Ability to make sound compensability and reserving decisions and explain them clearly
• Knowledge of Hawaii WC statutes and ability to apply them accordingly; stay current on reporting requirements and flag compliance risks
• Calm, composure, and professionalism in difficult conversations; ability to set expectations clearly and follow through

Work Location

This role is based out of our Hawaii Kai office. We offer a flexible hybrid schedule that gives you the structure of in-person collaboration with the flexibility of remote work.

• In office: Tuesday – Thursday
• Remote: Monday & Friday

Pay

The base compensation for this position is $60,000.00 – $75,000.00 per year depending on experience and qualifications.

Benefits

• Fully paid healthcare
• 401(k) matching
• Paid parental leave
• Student loan assistance
• Employee assistance programs
• Paid time off
• Reimbursement for certifications, conferences, and memberships
• Internal career advancement opportunities

ProService is a Hawaii-based PEO combining payroll, HR, and benefits expertise with purpose-built technology — all backed by the best local service in Hawaii. Backed by Silver Lake and recognized as one of Hawaii’s Best Places to Work for 20 consecutive years, we’re a team of high performers united by one mission: Empowering Employers to Succeed in Hawaii.

Our culture emphasizes assuming the best in each other, giving feedback focused on what’s right—not who’s right—and showing up every day as a community. We offer a high-energy, value-driven environment with endless career advancement opportunities.