Senior Remote Claims Adjuster — Workers' Comp Specialist

EMPLOYERS; United States; Remote; USD 70,000 - 106,000; Full time

Job summary

EMPLOYERS is seeking a Senior Claims Adjuster I for a remote (WFH) role focused on Florida workers' compensation claims. The position handles medical and indemnity benefits, complex issues, and high exposure cases, with supervision minimal.

The role requires 7+ years of claims experience, strong communication, and solid knowledge of WC laws. You will mentor teammates and work independently to move claims toward closure.

Qualifications

• 7+ years of related claims experience including complex claim handling.
• Superior communication and customer service skills; proficiency with imaged environment.
• Knowledge of workers’ compensation laws; adherence to statutes, regulations and company policies.
• Self-motivated with the ability to work independently with minimal direction.
• Excellent analytical, problem-solving and decision-making skills.
• Equivalent combinations of education and experience may be considered.

Responsibilities

• Completes initial contacts to obtain information, verify coverage, determine compensability and develop a plan of action.
• Independently analyzes case facts to establish timely reserves using knowledge of medical disabilities and related costs.
• Collaborates with Corporate Claims to evaluate and mitigate high exposure losses.
• Provides timely customer service and maintains professional communications with internal and external customers.
• Evaluates and pays benefits in compliance with procedures; files state forms when needed.
• Manages medical treatment to move the claim forward and contains costs and exposure.
• Reviews litigation; directs legal strategy and assists in preparing the case for litigation.
• Performs detailed settlement analysis and recommends settlement value based on WC principles, subrogation, offsets, and durations.

Skills

Claims experience

Communication

Analytical thinking

Independent work

Multitasking

Education

Bachelor’s degree

Job description

EMPLOYERS is seeking a Senior Claims Adjuster I for a remote (WFH) role focused on Florida workers' compensation claims. The position handles medical and indemnity benefits, complex issues, and high exposure cases, with supervision minimal.

The role requires 7+ years of claims experience, strong communication, and solid knowledge of WC laws. You will mentor teammates and work independently to move claims toward closure.