Associate Workers' Compensation Claims Adjuster

About the role

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.

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, and we’ll help support you in obtaining proper licensing.

Qualifications

• You’ve managed a high-volume WC caseload combined with tight deadlines and diary management
• You make sound compensability and reserving decisions—and you can explain them clearly
• You know Hawaii WC statutes and can apply them accordingly
• You stay current on reporting requirements and flag compliance risks before they become problems
• You bring calm, composure, and professionalism to difficult conversations; setting expectations clearly and following through

Skills

Structured approach to work, ability to manage multiple tasks simultaneously, attention to detail, strong communication skills, and the ability to handle complex cases with professionalism.

Benefits

Flexible hybrid schedule, fully paid healthcare, 401(k) matching, paid parental leave, student loan assistance, employee assistance programs, and paid time off.

Pay

$60,000.00 – $75,000.00 per year depending on experience and qualifications.

Schedule

Hawaii Kai, Oahu — Hybrid: In office: Tuesday – Thursday | Remote: Monday & Friday