Experienced Workers' Comp Medical-Only Claims Adjuster

Davies North America; United States; Remote; USD 52,000 - 55,000; Full time

Benefits offered by this job

Health, dental, and vision plans

401(k) plan with employer matching

Paid time off and paid holidays

Life insurance and disability coverage

Job summary

Davies North America is seeking a Workers' Compensation Medical Only Claims Adjuster to manage indemnity and medical-only claims from intake to resolution. You will investigate, evaluate, and adjudicate in line with client expectations and jurisdictional rules.

The role requires 3+ years WC claims experience, an active FL license, and the ability to handle multiple claims in a fast-paced environment while coordinating return-to-work and settlements.

Qualifications

• 3+ years of Workers' Compensation claims handling experience.
• Active Florida license or ability to obtain.
• Experience with medical-only, lost time, or blended WC portfolios preferred.
• Strong knowledge of WC laws, benefit structures, and claims processes.
• Experience managing indemnity payments and return-to-work programs.
• Ability to handle multiple claims in a fast-paced environment.
• Strong investigative, analytical, and decision-making skills.
• Effective negotiation and problem-solving abilities.
• Excellent written and verbal communication skills.
• Proficiency with claims management systems and related technology.
• Active adjuster license(s) or ability to obtain as required.

Responsibilities

• Own Workers' Compensation claims from intake through closure.
• Determine compensability and benefit eligibility.
• Establish and adjust reserves based on claim exposure.
• Conduct investigations, including interviews and documentation review.
• Develop and execute claim strategies.
• Identify opportunities for early resolution.
• Monitor treatment plans and coordinate return-to-work efforts.
• Administer indemnity benefits in compliance with jurisdictional requirements.
• Coordinate with defense counsel on litigated claims.
• Support hearings, mediations, and settlements.
• Provide timely updates to clients and stakeholders.
• Ensure compliance with state regulations and internal standards.
• Maintain regular attendance and be available during work hours.

Skills

WC claims handling

Investigation & case management

Negotiation

Communication skills

Medical knowledge

Claims management systems

Active adjuster license

Tools

Claims management systems

Job description

Davies North America is seeking a Workers' Compensation Medical Only Claims Adjuster to manage indemnity and medical-only claims from intake to resolution. You will investigate, evaluate, and adjudicate in line with client expectations and jurisdictional rules.

The role requires 3+ years WC claims experience, an active FL license, and the ability to handle multiple claims in a fast-paced environment while coordinating return-to-work and settlements.