Senior Workers' Comp Claims Adjuster - Complex Indemnity

Elite Tek Services, Inc.; Tempe (AZ); On-site; USD 85,000 - 110,000; Full time

Job summary

Elite Tek Services, Inc. in Tempe, AZ, seeks an experienced Senior Workers' Compensation Claims Adjuster to manage complex indemnity claims from inception through resolution.

You will independently handle investigations, determine compensability, administer benefits, and work with claimants, providers, clients, and defense counsel to move claims toward timely resolution. The ideal candidate brings 5+ years of workers' compensation experience, strong knowledge of statutes and medical terminology,

Qualifications

• Five (5) or more years of workers' compensation claims handling experience.
• Experience independently managing complex indemnity claims.
• Strong knowledge of workers' compensation statutes, regulations, and medical terminology.
• Experience investigating claims, determining compensability, managing reserves, and negotiating settlements.
• Excellent written and verbal communication skills.
• Ability to communicate with claimants, clients, attorneys, medical providers, and internal teams.
• Ability to manage multiple priorities with accurate documentation.
• Applicable claims adjuster licenses and/or certifications as required by state regulations.

Responsibilities

• Independently manage an average caseload of ~130 workers' compensation claims, including complex indemnity claims.
• Initiate and conduct timely claims investigations.
• Determine compensability and administer benefits per state laws and guidelines.
• Develop and execute claim action plans for timely resolution.
• Manage medical treatment and billing, including authorizations where appropriate.
• Calculate and administer indemnity benefits and approve payments within authority.
• Refer claims to outside defense counsel and manage litigation activities as needed.
• Manage recoveries, including deductibles and subrogation.
• Communicate with clients, claimants, providers, and vendors on claims issues.
• Establish and maintain accurate reserves following guidelines.
• Negotiate settlements and secure appropriate settlement authority.
• Maintain thorough claim documentation, diaries, and file reviews.
• Keep clients informed of significant developments, injury trends, and safety concerns.
• Conduct independent file reviews to ensure compliance with handling standards.

Skills

Analytical skills

Organizational skills

Problem-solving

Written and verbal communication

Client, claimant, and attorney liaison

Multitasking

Education

Bachelor's degree in related field

Claims adjuster licenses/certifications per state

Tools

Microsoft Word

Microsoft Excel

Job description

Elite Tek Services, Inc. in Tempe, AZ, seeks an experienced Senior Workers' Compensation Claims Adjuster to manage complex indemnity claims from inception through resolution.

You will independently handle investigations, determine compensability, administer benefits, and work with claimants, providers, clients, and defense counsel to move claims toward timely resolution. The ideal candidate brings 5+ years of workers' compensation experience, strong knowledge of statutes and medical terminology,