Senior WC Claims Adjuster II — Remote, High-Impact

EMPLOYERS; Dallas (TX); On-site; USD 80,000 - 120,000; Full time

Benefits offered by this job

Comprehensive benefits

Job summary

EMPLOYERS is seeking a Senior Work Comp Claims Adjuster II for a 100% remote opportunity across the United States. The role handles high or catastrophic workers’ compensation claims, including complex litigation, with guidance to ensure timely, accurate reserves and settlements.

Responsibilities include data integrity, independent case analysis, medical treatment coordination, collaboration with defense counsel, and mentoring teammates.

Qualifications

• 10+ years of workers’ compensation claims experience including complex claims handling.
• Superior communication and customer service skills.
• Knowledge of workers’ compensation laws and ability to adhere to statutes, regulations and company policies.

Responsibilities

• Completes initial contacts to obtain necessary information, verify coverage, determine compensability and develop a plan of action for work comp claims.
• Maintains workers' compensation claim data integrity.
• Independently analyzes case facts to establish timely reserves using knowledge of medical disabilities and related costs.
• Collaborates with Corporate Claims to mitigate high exposure.
• Provides timely customer service within established best practices.
• Maintains professional communications with internal and external customers.
• Evaluates and pays benefits in compliance with procedures and guidelines.
• Manages or coordinates medical treatment to move the claim forward.
• Reviews litigation and legal issues; directs strategy and participates in case preparation.
• Collaborates with defense attorney to move claims to resolution.
• Performs detailed settlement analysis and recommends settlement value.

Skills

Communication

Customer service

Analytical thinking

Education

Bachelor’s degree or equivalent

Job description

EMPLOYERS is seeking a Senior Work Comp Claims Adjuster II for a 100% remote opportunity across the United States. The role handles high or catastrophic workers’ compensation claims, including complex litigation, with guidance to ensure timely, accurate reserves and settlements.

Responsibilities include data integrity, independent case analysis, medical treatment coordination, collaboration with defense counsel, and mentoring teammates.