Lost Time WC Claims Adjuster — Investigations & Settlements

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

Job summary

The Jonus Group is seeking a Lost Time Workers' Compensation Claims Adjuster in the United States to join our growing team. The role requires strategic thinking, investigative prowess, and the ability to deliver excellent service while handling a high-volume caseload.

Responsibilities include conducting investigations, gathering information, reviewing medical bills, filing with the Industrial Commission, and coordinating with attorneys and case management.

Qualifications

• Minimum of 5 years in workers' compensation claims, with at least 3 years in Lost Time.
• Ability to work independently and manage a high-volume caseload.
• Excellent communication with insureds, injured workers, and attorneys.
• Fluent in English; Spanish language skills are a plus.

Responsibilities

• Investigate to determine coverage and liability for new claims.
• Gather information from employers and injured employees, including statements.
• Review medical bills for proper payment and refer for audit when needed.
• File required forms with the Industrial Commission and ensure compliance.
• Establish and adjust reserves for claims.
• Coordinate medical case management and ensure necessary care for injured workers.
• Collaborate with attorneys and represent the company at mediations/hearings.
• Utilize ImageRight and proprietary claims software to manage claims efficiently.

Skills

English fluency

Interpersonal skills

Problem solving

Independent work

Caseload management

Spanish a plus

Tools

ImageRight

Claims software

Job description

The Jonus Group is seeking a Lost Time Workers' Compensation Claims Adjuster in the United States to join our growing team. The role requires strategic thinking, investigative prowess, and the ability to deliver excellent service while handling a high-volume caseload.

Responsibilities include conducting investigations, gathering information, reviewing medical bills, filing with the Industrial Commission, and coordinating with attorneys and case management.