Remote Workers' Comp Adjuster - NM Specialist

Davies Group; Northern (KY); Hybrid; USD 85,000 - 92,000; Full time

Benefits offered by this job

Medical, dental, and vision plans

401(k) plan with employer matching

Time-off policies including DTO and P​

Paid holidays

Life insurance and disability coverage

Job summary

Davies North America is seeking an experienced Workers' Compensation Adjuster to join our Claims Administration & Adjusting team. This remote role supports New Mexico operations; you will investigate and evaluate losses and develop action plans to resolve claims promptly.

Candidates must reside in New Mexico, hold an NM adjuster license, and have 5–7 years of workers' compensation experience. The position offers a permanent full-time arrangement with competitive compensation.

Qualifications

• Ability to understand and follow oral and/or written policies, procedures and instructions.
• Ability to perform a wide variety of duties and responsibilities with accuracy and speed, while meeting time-sensitive deadlines.
• Ability to conduct investigations in multi-party situations.
• Ability to use standard or customized software applications appropriate to assigned tasks.
• Ability to prepare and present accurate, reliable and factual reports with recommendations.
• Thorough knowledge of current principles and practices associated with claims investigations, adjustment and related practices.
• Extensive knowledge of medical and legal terminology with a thorough understanding of Legal principles/litigation management.
• Ability to handle confidential information.
• Ability to communicate effectively with others both orally and in writing.
• Ability and willingness to learn quickly and utilize new skills because of rapidly changing information and/or technology.
• Ability to comprehend multi-state laws and regulations to assist other offices, as necessary

Responsibilities

• Determines extent of insurance coverage and compensability on each filed claim
• Investigates claims, including interviewing employees, employers and witnesses
• Obtains necessary records, including but not limited to, hospital records, police reports, physician records, etc.
• EDI and CMS/Section 111 reporting
• Negotiates settlements for resolutions with claimants and their attorneys
• Maintains control of litigation activities and costs per account requirements
• May be asked to mentor, train and/or share expertise with other Davies staff
• Attends meetings; conferences; workshops or training sessions; and reviews written material to maintain current knowledge on principles, practices and new developments in assigned work areas
• Maintains and meets specific licensing requirements
• Responds to client questions and comments in a courteous and timely manner
• Is responsible for catastrophic losses, complex litigation, and other sensitive issues

Skills

Policy understanding

Multitasking

Investigations

Software proficiency

Reporting

Legal terminology

Confidentiality

Communication

Fast learner

Regulatory knowledge

Tools

None

Job description

Davies North America is seeking an experienced Workers' Compensation Adjuster to join our Claims Administration & Adjusting team. This remote role supports New Mexico operations; you will investigate and evaluate losses and develop action plans to resolve claims promptly.

Candidates must reside in New Mexico, hold an NM adjuster license, and have 5–7 years of workers' compensation experience. The position offers a permanent full-time arrangement with competitive compensation.