Remote Workers' Comp Claims Adjuster I

emcins; United States; Remote; USD 60,000 - 83,000; Full time

Job summary

EMC is seeking a workers' compensation claims adjuster to join our US-based team. The role focuses on reviewing claims, investigating coverage, and coordinating medical care with insureds and providers.

You will handle wage benefits, return-to-work collaborations, subrogation opportunities, and settlement negotiations. This position supports our commitment to fair, responsive service and requires timely, accurate documentation. Remote work from anywhere in the United States is eligible.

Qualifications

• Bachelor's degree or equivalent relevant experience.
• One year of workers' compensation claims adjusting experience.
• Ability to obtain state licenses within one year.
• Familiarity with Oklahoma, Kansas, Arkansas, Kentucky preferred.

Responsibilities

• Review notices, contracts, and state requirements to determine coverage and compensability.
• Conduct timely claim investigations by contacting involved parties and gathering reports.
• Document activity, maintain diaries, set reserves, and ensure timely resolution.
• Review medical records and invoices to coordinate care and expenses.
• Administer wage benefits and monitor changes.
• Coordinate return-to-work efforts with involved parties.
• Identify subrogation opportunities and refer to specialists as needed.
• Investigate and resolve eligibility and coverage issues; communicate decisions.
• Prepare settlement evaluations and negotiation strategies.
• Collaborate with attorneys, mediations, and other teams to resolve claims.
• Promote claims programs like OCN, RTW, SPP; support initiatives.

Skills

Claim investigations

Insurance contracts knowledge

Communication skills

Analytical thinking

Attention to detail

Education

Bachelor's degree or equivalent experience

Tools

Claims systems

Microsoft Office

Medical terminology

Job description

EMC is seeking a workers' compensation claims adjuster to join our US-based team. The role focuses on reviewing claims, investigating coverage, and coordinating medical care with insureds and providers.

You will handle wage benefits, return-to-work collaborations, subrogation opportunities, and settlement negotiations. This position supports our commitment to fair, responsive service and requires timely, accurate documentation. Remote work from anywhere in the United States is eligible.