Senior Workers' Comp Claims Specialist — Hybrid/Remote

Claims Resolution Corporation Inc.; New York (NY); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Paid time off

Medical, dental, and vision insurance

401(k)

HRA & FSA

Group life, STD, and LTD insurance

Job summary

Claims Resolution Corporation, Inc. is seeking a mid-level Workers’ Compensation Adjuster II to manage a caseload of complex medical treatment claims and litigation across New Jersey and/or Pennsylvania.

The role focuses on investigation, evaluation, and timely resolution while maintaining client-specific instructions and compliant reserves. The position supports hybrid, remote, or in-person work arrangements for suitable candidates in NJ, PA, or DE, and emphasizes collaboration with claimants,

Qualifications

• 4+ years of handling Medical Only/Workers’ Compensation claims.
• Strong attention to detail and investigative mindset.
• Excellent written, verbal, and interpersonal communication skills.
• Proficient in Microsoft Office, internet-based systems, and claims software.

Responsibilities

• Manage a caseload of workers' compensation claims involving complex medical treatment and litigation.
• Investigate, evaluate, and resolve lost time claims in compliance with NJ and/or PA workers' compensation laws.
• Establish and maintain accurate financial reserves; adjust reserves as claim conditions evolve.
• Report to excess carriers in accordance with policy thresholds and contractual obligations.
• Coordinate with medical providers, nurse case managers, and legal counsel to ensure appropriate treatment and litigation strategy.
• Attend mediations, depositions, and hearings as required.
• Communicate effectively with injured workers, employers, attorneys, and internal stakeholders.
• Maintain detailed and timely documentation in claims management systems.
• Prepare comprehensive reports and updates for clients and internal leadership.

Skills

Attention to detail

Investigative mindset

Communication

Tools

Microsoft Office

Claims software

Job description

Claims Resolution Corporation, Inc. is seeking a mid-level Workers’ Compensation Adjuster II to manage a caseload of complex medical treatment claims and litigation across New Jersey and/or Pennsylvania.

The role focuses on investigation, evaluation, and timely resolution while maintaining client-specific instructions and compliant reserves. The position supports hybrid, remote, or in-person work arrangements for suitable candidates in NJ, PA, or DE, and emphasizes collaboration with claimants,