Lost Time WC Claims Adjuster — Investigations & Care

Jonus Group; Pittsburgh (Allegheny County); On-site; USD 85,000 - 100,000; Full time

Job summary

Jonus Group is seeking a Lost Time Workers' Compensation Claims Adjuster in the United States to join a growing team. The role demands a strategic mindset, investigative skills, and the ability to work independently while delivering exceptional service.

With 5+ years in workers' compensation claims, you will handle investigations, communicate with employers and injured workers, review medical bills, file required forms, and coordinate medical case management. Proficiency in ImageRight is a plus.

Qualifications

• Minimum of 5 years of experience in Workers' Compensation claims handling, with at least 3 years in Lost Time claims.
• Strong problem-solving skills and ability to work independently.
• Proven ability to prioritize tasks and manage a high-volume caseload.

Responsibilities

• Conduct thorough investigations to determine coverage and liability for new claims.
• Communicate with employers and injured employees to gather information, including statements.
• Review medical bills to ensure proper payment and refer bills for audit when necessary.
• File required forms with the Industrial Commission and maintain compliance with workers' compensation laws.
• Establish and adjust appropriate reserves for claims.
• Coordinate medical case management services and ensure injured employees receive necessary care.
• Collaborate with attorneys on legal matters and represent the company at mediations and hearings.
• Utilize proprietary claims software and ImageRight to manage claims efficiently.

Skills

Investigation

Communication

Claims software

Industry knowledge

Bilingual English/Spanish

Tools

ImageRight

Proprietary claims software

Job description

Jonus Group is seeking a Lost Time Workers' Compensation Claims Adjuster in the United States to join a growing team. The role demands a strategic mindset, investigative skills, and the ability to work independently while delivering exceptional service.

With 5+ years in workers' compensation claims, you will handle investigations, communicate with employers and injured workers, review medical bills, file required forms, and coordinate medical case management. Proficiency in ImageRight is a plus.