Senior Claim Adjuster - Contract - Remote

Davies Talent Solutions; United States; On-site; USD 70,000 - 90,000; Full time

Job summary

A leading insurance firm in the United States seeks a Senior Claim Adjuster to investigate claims and ensure timely resolution. The role includes conducting thorough investigations, managing multi-party negotiations, and mentoring staff. Ideal candidates have 4-6 years of relevant experience and a strong grasp of compensation claims processes. The position is contract-based, targeting mid-senior level professionals.

Qualifications

• 4-6 years handling workers’ compensation or liability claims.
• State-specific licensing requirements maintained.

Responsibilities

• Determine insurance coverage and compensability for filed claims.
• Conduct investigations, including interviews and record collection.
• Manage EDI and CMS/Section 111 reporting.
• Utilize preferred vendors and maintain compliance.
• Prepare accurate reports for clients and excess carriers.
• Negotiate settlements with claimants and attorneys.
• Control litigation activities and costs.
• Mentor and train staff as needed.
• Stay current on industry practices through meetings and training.
• Handle catastrophic losses, complex litigation, and sensitive issues.

Skills

Claims investigations

Medical and legal terminology

Multi-party investigations

Claims software and reporting tools

Communication skills

Deadline management

Multi-state law comprehension

Education

College degree or equivalent business experience

Job description

Senior Claim Adjuster

We are seeking an experienced Senior Claim Adjuster to investigate and evaluate losses, develop action plans, and bring claims to resolution in a timely manner.

About the Role

• Determine insurance coverage and compensability for filed claims
• Conduct investigations, including interviews and record collection
• Manage EDI and CMS/Section 111 reporting
• Utilize preferred vendors and maintain compliance
• Prepare accurate reports for clients and excess carriers
• Negotiate settlements with claimants and attorneys
• Control litigation activities and costs
• Mentor and train staff as needed
• Serve as backup to supervisor or manager when required
• Stay current on industry practices through meetings and training
• Handle catastrophic losses, complex litigation, and sensitive issues

Required Knowledge & Skills

• Strong understanding of claims investigations and adjustment practices
• Extensive knowledge of medical and legal terminology
• Ability to manage multi‑party investigations and litigation
• Proficiency with claims software and reporting tools
• Excellent communication and documentation skills
• Ability to meet deadlines and adapt to changing technology
• Multi‑state law and regulation comprehension

Qualifications

• 4-6 years handling workers’ compensation or liability claims
• College degree or equivalent business experience
• State‑specific licensing requirements maintained

Seniority level

Mid‑Senior level

Employment type

Contract

Job function

Quality Assurance and Administrative

Industries

Insurance