Senior Workers' Comp Claims Adjuster – High-Exposure

RCM&D; Baltimore (MD); On-site; USD 75,000 - 85,000; Full time

Benefits offered by this job

Healthcare benefits

Life and disability insurance

Paid time off

401(k) plan

Job summary

RCM&D seeks a Senior Claims Adjuster to independently manage complex Workers’ Compensation claims, including high‑exposure and litigated losses across jurisdictions. You will apply advanced strategies in compensability, medical management, reserves, and settlement while mentoring junior staff and supporting client relationships.

The role requires strong negotiation, analytical skills, and the ability to lead claim strategy from investigation through resolution, with collaboration across

Qualifications

• High school diploma or GED required; college coursework preferred.
• Minimum five years of progressive Workers’ Compensation claims handling, including complex/litigated cases.
• Required adjuster licenses and continuing education for jurisdictions in good standing.
• Strong investigative, medical/disability management, reserving, and regulatory skills.
• Excellent written/verbal communication, negotiation, organization, and time management.

Responsibilities

• Independently investigate, evaluate, and manage complex, high-exposure workers’ compensation claims through resolution.
• Determine compensability by timely investigations and applying jurisdictional requirements.
• Develop action plans addressing compensability, medical treatment, disability, return‑to‑work, reserves, and settlement.
• Coordinate medical treatment, review documentation, and apply AMA guidelines.
• Lead return‑to‑work efforts with stakeholders and coordinate vendor resources.
• Manage reserves based on exposure, medical data, and litigation posture; monitor progress.

Skills

Technical judgment

Investigations

Negotiation

Client communication

Mentoring

Education

High school diploma or GED

Adjuster licenses

Tools

Spear experience

Microsoft Office

Claim-management systems

Job description

RCM&D seeks a Senior Claims Adjuster to independently manage complex Workers’ Compensation claims, including high‑exposure and litigated losses across jurisdictions. You will apply advanced strategies in compensability, medical management, reserves, and settlement while mentoring junior staff and supporting client relationships.

The role requires strong negotiation, analytical skills, and the ability to lead claim strategy from investigation through resolution, with collaboration across