Workers Compensation Claims Adjuster

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

📋 Description

• Oversee a portfolio of moderately complex casualty claims from the initial intake to final resolution.

• Perform comprehensive investigations, evaluate liability, and assess damages by following established protocols.

• Work in conjunction with underwriting, legal teams, and both internal and external stakeholders as necessary to ensure thorough claim evaluations.

• Detect and refer potentially suspicious claims to the Special Investigations Unit.

• Implement comparative negligence laws and state-specific regulations in claim evaluations.

• Set appropriate reserves, authorize payments, and exhibit financial insight within the designated authority.

• Leverage technology and data tools to improve efficiency and accuracy in claims processing.

• Engage directly with claimants, legal representatives, and third parties to negotiate equitable resolutions.

• Keep meticulous and compliant records of claim activities and communications.

• Assist in subrogation initiatives and risk transfer opportunities to benefit both insured parties and business partners.

• Manage sensitive communications with professionalism and simplify complex information for varied audiences.

⛳️ Requirements

• An associate degree is required; a bachelor's degree is preferred, or a combination of education and experience.

• Generally requires 1-4 years of relevant experience in claims handling.

• Perform independent assessments of contractual indemnification.

• Independently manage indemnity, medical, and litigation/resolution processes.

• Competent in basic computer navigation and capable of utilizing fundamental software systems/applications (Microsoft Office Suite) and the internet.

• Learn to negotiate independently within authority and grasp common strategies for moderately complex claim resolutions.

• Familiarity with various types of insurance products and procedures.

• Conduct thorough investigations; pinpoint critical issues and gather supporting evidence.

• Deliver effective and empathetic customer service; address routine inquiries and issues.

• Proficient in using personal computers and other standard office equipment.

• Capable of utilizing all Microsoft Office products.

• Ability to sit and/or stand for prolonged periods.

• Required to work on-site as necessary.

• Must be able to thrive in a fast-paced, evolving, or stressful environment.

• Capable of performing work in a noisy/loud office setting.

• May need to have and maintain a reliable home-based internet connection.

🏝️ Benefits

• Opportunity to travel as required.

• Must secure and maintain the appropriate state adjuster licenses.

• Engage in team collaboration, problem-solving discussions, and cross-functional coordination.

• Participate in ongoing training and education to uphold licensing and remain up-to-date with industry standards.

• Mentor entry-level claim handlers and share best practices gained through training and experience.