Remote Mid-Atlantic Workers' Comp Claims Adjuster

Jonus Group; Philadelphia (Philadelphia County); Remote; USD 60,000 - 90,000; Full time

Job summary

Jonus Group is seeking a skilled Workers' Compensation Claims Adjuster for a remote role in the Mid-Atlantic region. The candidate will analyze, investigate, and resolve claims, ensuring accuracy and integrity in compliance with regional laws.

The ideal candidate has 3–5 years of experience, a valid Mid-Atlantic claims adjuster license, and proficiency with claims management software and Office tools. Strong communication and organizational skills are essential for remote collaboration.

Qualifications

• High school diploma or equivalent required; Bachelor’s degree in a related field preferred.
• 3–5 years of experience as a workers' compensation claims adjuster or related role.
• Must hold a valid claims adjuster license in at least one Mid-Atlantic state (e.g., VA, MD, DE, PA, NJ).
• Industry certifications (e.g., AIC, CPCU) are a plus.

Responsibilities

• Investigate and evaluate workers’ compensation claims to determine coverage, compensability, liability, and benefits owed.
• Review medical and employment records and other documents to assess claims.
• Interpret and apply Mid-Atlantic workers' compensation laws, statutes, and regulations.
• Communicate with injured employees, employers, medical providers, attorneys, and internal stakeholders to resolve claims.
• Authorize treatment and payments within designated authority levels while ensuring compliance with policies and state laws.
• Handle claim settlements, reviews, and negotiations ethically.
• Prepare reports documenting claim activity, reserves, and resolution strategies.
• Evaluate ongoing medical treatment plans and facilitate return-to-work options when feasible.
• Collaborate with legal teams to support litigation and dispute resolution.

Skills

Analytical skills

Problem solving

Communication skills

Organizational skills

Microsoft Office

Education

High school diploma or equivalent

Bachelor’s degree preferred

Tools

Claims management software

Microsoft Office Suite

Job description

Jonus Group is seeking a skilled Workers' Compensation Claims Adjuster for a remote role in the Mid-Atlantic region. The candidate will analyze, investigate, and resolve claims, ensuring accuracy and integrity in compliance with regional laws.

The ideal candidate has 3–5 years of experience, a valid Mid-Atlantic claims adjuster license, and proficiency with claims management software and Office tools. Strong communication and organizational skills are essential for remote collaboration.