Work Comp Insurance Adjuster

This is a fully remote position, open to applicants in Texas.

📋 Description

• Investigate and adjust workers’ compensation claims following established procedures, CCMSI guidelines, and direct oversight.

• Review medical, legal, and miscellaneous invoices to assess their reasonableness and relevance to ongoing workers’ compensation claims.

• Negotiate disputed bills to reach resolutions.

• Authorize and facilitate workers’ compensation claim payments utilizing a claim payment program, industry standards, and settlement authority.

• Negotiate settlements with claimants and attorneys in accordance with client authorization.

• Assist in selecting and overseeing defense attorneys.

• Evaluate and monitor subrogation claims for resolution.

• Prepare detailed reports on claims, payments, and reserves.

• Compile reports and oversee files for excess insurers.

• Adhere to team service commitments.

• Provide high-quality claim service to clients.

• Manage a portfolio of moderately complex Texas workers’ compensation claims across various accounts and industries.

• Make compensability decisions and drive timely and effective claim resolutions.

⛳️ Requirements

• A minimum of 5 years experience in Texas Workers’ Compensation claims management or an equivalent combination of experience and education.

• A Texas Adjusting License is mandatory.

• Exceptional oral and written communication skills.

• Strong organizational capabilities and the ability to operate with minimal supervision.

• Ability to coordinate, prioritize, and manage multiple tasks effectively.

• Flexibility, initiative, and adaptability in a dynamic, fast-paced environment.

• Strong discretion and capacity to maintain confidentiality.

• Ability to collaborate effectively as part of a team.

• Reliable and predictable attendance during client service hours.

• Responsiveness to the needs of both internal and external clients.

• Proficiency in Microsoft Office applications, including Word, Excel, and Outlook.

• An associate degree is preferred but not mandatory.

• Bilingual proficiency in Spanish is highly valued, though not required.

• Must be available to work from 8:00 am to 4:30 pm CST.

• Visa sponsorship is not available.

🏝️ Benefits

• 4 weeks of paid time off accrued throughout the year in accordance with company policy.

• 10 paid holidays during the first year.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Life insurance coverage.

• Disability insurance coverage.

• 401(k) retirement plan.

• Employee Stock Ownership Plan (ESOP).

• Opportunities for internal training and advancement.

• A supportive, team-oriented work environment.

• Potential eligibility for bonuses or additional forms of compensation.

• Reasonable accommodations available throughout the application and hiring process.