Workers' Compensation Claim Adjuster

Job Summary

We are seeking an experienced and motivated Workers’ Compensation Claim Adjuster to manage a diverse portfolio of claims with professionalism, empathy, and strong technical skill. With 5–10 years of experience, you’ll bring seasoned judgment to claim investigations, compensability decisions, and timely resolution strategies. This role provides an excellent opportunity to deepen your expertise and serves as a developmental step toward more senior claim positions.

Responsibilities

• Investigate and adjust workers compensation claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision.
• Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims.
• Negotiate any disputed bills for resolution.
• Authorize and make payment of workers compensation claims utilizing a claim payment program in accordance with industry standards and within settlement authority.
• Negotiate settlements with claimants and attorneys in accordance with client's authorization.
• Absorb and supervise defense attorneys.
• Assess and monitor subrogation claims for resolution.
• Prepare reports detailing claims, payments and reserves.
• Provide reports and monitor files, as required by excess insurers.

Qualifications

• Excellent oral and written communication skills.
• Self‑starter with strong organizational skills and the ability to work with minimal supervision.
• Proven ability to coordinate, prioritize, and manage multiple responsibilities.
• Flexibility, initiative, and adaptability in a fast‑paced, rapidly changing environment.
• Strong discretion and ability to maintain confidentiality.
• Ability to work effectively as part of a team.
• Reliable, predictable attendance within client service hours.
• Responsiveness to internal and external client needs.
• Ability to communicate clearly and professionally, both verbally and in writing.
• 5 to 10 years of Workers’ Compensation claims management experience or equivalent combination of experience and education.
• Proficiency with Microsoft Office programs (Word, Excel, Outlook, etc.).
• Adjuster’s license required based on jurisdiction (FL, GA, SC, NC, VA and WV).