Workers' Compensation Claims Adjuster

About the role

ProService Hawaii is seeking a Workers' Compensation Claims Adjuster to oversee the entire lifecycle of assigned indemnity claims, from initial reports through resolution. This role requires high visibility and client-facing responsibilities, emphasizing ownership and decision-making.

Responsibilities

• Manage a caseload of approximately 90–100 active indemnity/lost time claims, ensuring timely and cost-effective resolution
• Conduct thorough investigations, determine compensability, establish accurate reserves within 48 hours, and develop clear, forward-looking claim strategies
• Actively manage medical treatment plans using evidence-based guidelines (ODG), initiate IMEs when necessary, and coordinate return-to-work and vocational strategies to reduce indemnity duration
• Ensure strict compliance with Hawaii workers' compensation statutes, regulatory deadlines, and benefit payments, maintaining zero missed deadlines and audit-ready files
• Prepare for and represent employer/carrier at hearings before the Hawaii DLIR, Disability Compensation Division
• Communicate proactively with employers, injured workers, attorneys, and medical providers, setting expectations early, explaining decisions clearly, and managing escalations with composure and authority

Requirements

Proven success managing full-cycle workers' compensation claims, including indemnity and litigated files, is required. Must have experience with compensability decisions, reserve strategies, and complex file resolutions. Knowledge of Hawaii workers' compensation statutes and regulatory requirements is essential.

Qualifications

• Proven track record in managing full-cycle indemnity claims
• Experience with compensability decisions and reserve strategies
• Ability to manage medical treatment plans and initiate IMEs
• Strong understanding of Hawaii workers' compensation statutes and regulatory requirements
• Composure and professionalism under pressure

Skills

• Excellent communication skills
• Strong analytical and problem-solving abilities
• Knowledge of evidence-based guidelines and treatment protocols
• Ability to manage multiple tasks and meet deadlines

Benefits

ProService offers a competitive compensation package, including a base salary range of $76,000.00 – $98,000.00 per year, depending on experience and qualifications. Additional benefits include fully paid healthcare, 401(k) matching, paid parental leave, student loan assistance, employee assistance programs, and paid time off.

Pay

$76,000.00 – $98,000.00 per year

Schedule

Hawaii Kai, Oahu — Hybrid

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