Senior Claims Adjuster - Workers' Compensation

BASIC FUNCTION AND RESPONSIBILITY

The Sr. Claims Adjuster handles minor to complex workers’ compensation (WC) claims that may involve legal representation. This role involves independent investigation, coverage interpretation, and medical management in various state jurisdictions. This position handles claims with increased financial exposure and complexity, as well as litigated claims. You will work closely with internal and external partners to resolve claims promptly, fairly, and within authority limits, using modern claims technologies and best practices.

This role serves as a promotional opportunity for experienced adjusters who demonstrate advanced technical knowledge, sound judgment, and the ability to independently manage larger losses.

QUALIFICATIONS

• 7+ years of experience handling WC claims.
• Strong working knowledge of WC policy forms and endorsements, and coverage analysis with experience handling moderate to complex coverage matters.
• Demonstrated experience handling moderate to high-severity WC claims involving complex damages and higher financial exposure.
• Proficient in policy interpretation, exposure analysis, and jurisdictional claims practices across multiple states and Texas, specifically.
• Excellent negotiation, analytical, and customer service skills.
• Ability to communicate clearly and professionally.
• Proven ability to manage challenging conversations with policyholders.
• Strong organizational and time-management skills.
• Technical knowledge of commercial insurance laws, regulations, and best practices.
• Proven ability to manage competing priorities in a fast-paced environment.
• Strong written and verbal communication skills, with the ability to present information clearly and persuasively.
• Sound critical thinking, and problem solving capabilities.
• Outstanding customer service, attention to detail, and multi-tasking skills.
• Strong computer skills, including a strong knowledge of Microsoft applications (Outlook, Word, Excel).
• Strong working knowledge of claims technology platforms.
• Must have a valid adjuster license in designated home state (or willing to obtain one within 60 days after hire), as well as a Texas license, with the ability to obtain additional non residential adjuster licenses.
• Able to exercise independent judgment with very limited supervision in handling claims with an elevated reserve and settlement authority.
• Able to travel, as necessary.