Claims Adjuster – Workers Compensation

This is a fully remote position, open to applicants in Alabama, +3 more states.

📋 Description

• Evaluate mid- and upper-level workers' compensation claims to ascertain the benefits owed.

• Ensure the continuous adjudication of claims in alignment with company standards and industry best practices.

• Recognize subrogation claims and negotiate appropriate settlements.

• Oversee workers' compensation claims, encompassing compensability, benefits, reserves, and necessary state agency documentation.

• Create and manage claims action plans until resolution is achieved.

• Facilitate return-to-work initiatives and authorize claim payments.

• Process assigned claims and administer action plans in accordance with claim or client contracts.

• Communicate claim actions to claimants and clients effectively.

• Ensure proper documentation of claim files and accuracy of claims coding.

• Manage complex lifetime medical and/or defined-period medical claims when applicable, including state and physician filings and treatment decisions.

• Sustain professional relationships with clients.

⛳️ Requirements

• A bachelor's degree from an accredited college or university is preferred.

• Professional certification relevant to the line of business is preferred.

• A minimum of four (4) years of claims management experience or an equivalent combination of education and experience is required.

• Familiarity with workers' compensation jurisdictions: TX, MN, MI.

• TX licensing is required, or home state licensing is necessary for remote work.

• Capability to analyze claims and determine compensability and benefits owed.

• Strong analytical and conceptual thinking skills.

• Excellent judgment, problem-solving, and discretion abilities.

• Capacity to manage work-related stress and multiple priorities concurrently.

• Ability to meet deadlines consistently.

• Proficient computer keyboarding skills.

• Willingness to travel as needed.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunity to work in an agile environment.

• Career development and promotional growth opportunities.

• Medical, dental, and vision insurance effective from day one.

• 401(k) benefits available on day one.

• 401(k) matching.

• Paid time off (PTO).

• Disability insurance.

• Life insurance.

• Employee assistance program.

• Flexible spending account or health savings account options.

• Additional voluntary benefits available.

• Reasonable accommodations provided.