Senior Lost-Time Workers' Comp Claims Adjuster

Apex Systems; Birmingham (AL); On-site; USD 52,000 - 106,000; Full time

Benefits offered by this job

Benefits package

401K

ESPP

HSA

EAP

Job summary

Everforth Apex in Birmingham, AL is seeking a Lost-Time Claims Adjuster to independently manage workers' compensation claims from intake to closure. You will evaluate compensability, conduct investigations, arrange medical treatment, manage return-to-work, and negotiate settlements while ensuring compliance with state regulations.

Requirements include a bachelor’s degree (preferred), 5+ years WC claims adjusting, and an active Adjuster’s License; experience with EDI, CMS/Medicare, and NCCI is

Qualifications

• Bachelor’s degree preferred or equivalent experience.
• 5+ years of workers' compensation claims adjusting experience.
• Active Adjuster’s License required.
• Strong knowledge of EDI, CMS/Medicare, NCCI, and state reporting.

Responsibilities

• Evaluate compensability and liability on complex workers' compensation lost-time claims.
• Conduct investigations, obtain statements, and establish reserves.
• Coordinate medical treatment and manage return-to-work initiatives.
• Process lost-time benefits and authorize medical/indemnity payments.
• Negotiate settlements and manage litigated files to resolution.

Skills

Claims adjusting

EDI

CMS/Medicare

NCCI

State reporting

Education

Bachelor’s degree preferred

Tools

Claims management software

Job description

Everforth Apex in Birmingham, AL is seeking a Lost-Time Claims Adjuster to independently manage workers' compensation claims from intake to closure. You will evaluate compensability, conduct investigations, arrange medical treatment, manage return-to-work, and negotiate settlements while ensuring compliance with state regulations.

Requirements include a bachelor’s degree (preferred), 5+ years WC claims adjusting, and an active Adjuster’s License; experience with EDI, CMS/Medicare, and NCCI is