Claim Adjuster

Experis; Pune District; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

Experis in Pune is seeking an experienced Claims Adjustor to manage end-to-end workers' compensation claims in a US-shift role from office. Requirements include 2–5 years in Property & Casualty claims, strong knowledge of workers' compensation, and the ability to handle investigations, set reserves, negotiate settlements, and ensure regulatory compliance.

Licenses may be pursued as needed. Experience in claim adjudication and ability to present findings to senior stakeholders are essential.

Qualifications

• 2 to 5 years of experience in Property & Casualty (P&C) Claims Adjusting.
• Strong experience in Workers' Compensation Claims.
• Expertise in Claims Adjudication.
• Ability to independently manage claims from initiation to closure.

Responsibilities

• Handle end-to-end workers' compensation claims.
• Evaluate complex and high-value claims.
• Conduct claimant, insured, and medical-provider investigations.
• Assess compensability and make claim decisions.
• Set and manage reserves.
• Administer medical and indemnity benefits.
• Negotiate settlements and drive early claim resolution.
• Ensure compliance with statutory and regulatory requirements.
• Present claim findings to senior stakeholders.
• Act as primary contact for agents and insureds.
• Provide claim status updates and coverage guidance.
• Deliver excellent service to internal and external stakeholders.
• Improve claim handling processes and SOPs.

Skills

Strong Written & Verbal Communication

Analytical Skills

Critical Thinking

Problem Solving

Decision Making

Stakeholder Management

Workers' Compensation Claims Handling

Claim Adjudication

Reserve Management

Settlement Negotiation

Regulatory Compliance

Investigation & Liability Assessment

Education

California Insurance Adjuster License

Texas Insurance Adjuster License

CPCU Certification

AIC Certification

Job description

Job Description Summary: Claims Adjustor

Location: Pune
Work Mode: Work from Office
Shift: US Shift
Experience Required: 2 to 5 years

Core Requirements

Mandatory Experience

• 2 to 5 years of experience in Property & Casualty (P&C) Claims Adjusting
• Strong experience in Workers' Compensation Claims
• Expertise in Claims Adjudication
• Ability to independently manage claims from initiation to closure

Preferred Experience

• Medical management
• Litigation management
• Training or mentoring claims adjusters

Certifications (Preferred)

• California Insurance Adjuster License
• Texas Insurance Adjuster License
• CPCU Certification
• AIC Certification

Candidates should be willing to obtain and maintain state-specific adjuster licenses.

Key Responsibilities

Claims Management

• Handle end-to-end workers' compensation claims
• Evaluate complex and high-value claims
• Conduct claimant, insured, and medical-provider investigations
• Assess compensability and make claim decisions
• Set and manage reserves
• Administer medical and indemnity benefits
• Negotiate settlements and drive early claim resolution
• Ensure compliance with statutory and regulatory requirements
• Present claim findings to senior stakeholders

Customer Service

• Act as primary contact for agents and insureds
• Provide claim status updates and coverage guidance
• Deliver excellent service to internal and external stakeholders
• Improve claim handling processes and SOPs

Key Skills Required

Technical Skills

• Workers' Compensation Claims Handling
• Claim Adjudication
• Reserve Management
• Settlement Negotiation
• Regulatory Compliance
• Investigation & Liability Assessment

Behavioral Skills

• Strong Written & Verbal Communication
• Critical Thinking
• Analytical Skills
• Problem Solving
• Decision Making
• Stakeholder Management