Workers Compensation Claims Adjuster II

Job Description

Workers’ Compensation Claims Adjuster

Job Summary

Seeking an experienced and detail-oriented Workers’ Compensation Claims Adjuster to manage indemnity claims from initial report through resolution. This role requires a strong understanding of workers’ compensation laws and regulations, the ability to evaluate complex claims, and a commitment to timely, compliant, and customer-focused claim handling. Responsibilities include investigation, documentation, collaboration with vendors and medical partners, and proactive claim resolution.

Responsibilities

• Conduct three-point contact on all new losses within required timeframes, including outreach to the claimant, employer, and treating physician
• Investigate claims thoroughly to establish compensability, disability status, and treatment plans
• Maintain accurate and timely documentation of all claim activity, medical updates, and expense payments
• Develop and maintain an up-to-date action plan for each assigned indemnity claim to drive timely resolution
• Partner with medical case management to support early return-to-work initiatives and minimize extended disability exposure
• Coordinate the use of vendors as needed to support claim investigation and resolution
• Identify and refer suspected fraudulent claims to the appropriate special investigations unit
• Ensure compliance with applicable workers’ compensation laws, regulations, and internal guidelines
  
  

Compensation Package

• Base salary range: $80,000 – $98,000 annually (depending on experience)
• Competitive benefits package, paid time off, professional development opportunities, etc.
  
  

Qualifications / Requirements

• 3 – 5 years of workers’ compensation claims handling experience
• Demonstrated experience managing indemnity claims
• Familiarity with applicable workers’ compensation regulations and procedures
• Experience with 4850 claims handling or SIP exposure
• Strong organizational, analytical, and communication skills
  
  

Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer’s discretion.