Senior Workers' Comp Claims Adjuster - Remote Leader

EMC Insurance; United States; Remote; USD 79,000 - 120,000; Full time

Job summary

EMC Insurance in the United States is seeking a seasoned workers' compensation claims professional to own moderately to highly complex cases from intake to resolution. You will drive investigations, evaluate coverage and liability, set reserves, negotiate settlements, and identify risk and recovery opportunities while mentoring teammates and staying compliant with evolving regulations.

This role offers flexible remote work nationwide and opportunities to partner with clients and stakeholders to

Qualifications

• Bachelor’s degree or equivalent relevant experience
• Five years of claims adjusting experience or related experience
• Prior experience with a third party administrator (TPA) preferred
• INS, AIC, SCLA, WCLA and CPCU coursework or designation preferred
• Workers' compensation claims adjusting experience in specified jurisdictions preferred

Responsibilities

• Analyzes coverage to confirm losses are covered under client policies
• Initiates contact within 24 hours with all relevant parties (clients, claimants, employees, medical providers)
• Conducts thorough investigations, including fact-finding and recorded statements
• Develops and executes action plans to resolve claims efficiently
• Performs reserve analysis and sets/maintains appropriate reserves per client guidelines
• Negotiates settlements, participates in mediation, and manages payments within authority limits

Skills

Analytical thinking

Investigations

Negotiation

Communication

Education

Bachelor’s degree or equivalent experience

CPCU coursework or designation preferred

Tools

Claims systems

Job description

EMC Insurance in the United States is seeking a seasoned workers' compensation claims professional to own moderately to highly complex cases from intake to resolution. You will drive investigations, evaluate coverage and liability, set reserves, negotiate settlements, and identify risk and recovery opportunities while mentoring teammates and staying compliant with evolving regulations.

This role offers flexible remote work nationwide and opportunities to partner with clients and stakeholders to