Sr. Adjuster-Workers Comp Claims

CopperPoint Insurance Companies; Alpharetta (GA); Hybrid; USD 75,000 - 110,000; Full time

Benefits offered by this job

Medical, dental, vision

401(k) plan

Paid time off

Job summary

CopperPoint Insurance Companies in Alpharetta, GA, invites an experienced Senior Adjuster-Workers’ Comp to join our growing Southeast presence. You will analyze and adjudicate indemnity claims across GA/FL/NC/SC, ensuring timely benefits while managing reserves and cost drivers.

Hybrid work is available for candidates living within 50 miles of Georgia office. Collaborate with injured workers, policyholders, brokers, and attorneys; document decisions; negotiate settlements when appropriate; and

Qualifications

• Bachelor's degree in business administration, communications, or related field.
• At least three years of WC claims handling experience.
• Experience handling WC claims in GA, FL, NC, SC.
• Strong customer service, judgment and discretion.
• Extensive knowledge of WC regulations (DOI, NCCI, CDLE).
• Ability to analyze and apply workers’ comp laws.
• Stay current with statutory and industry changes.
• Set priorities and meet deadlines.

Responsibilities

• Analyze indemnity claims to determine compensability.
• Adjudicate claims ensuring timely indemnity and medical payments.
• Build relationships with injured workers, policyholders, brokers and agents.
• Document communications and claim activities.
• Develop action plans and reserves for indemnity claims.
• Establish cost drivers and data for reporting (NCCI).
• Manage claims to resolution following company standards.
• Identify and negotiate settlements with claimants/attorneys.
• Testify at hearings when necessary.
• Dispute resolution with claimants and attorneys.

Skills

Customer service

Time management

Judgment & discretion

Communication skills

Analytical thinking

Regulatory knowledge

Education

Bachelor's degree (business/communications/related field)

Job description

Come build with us. Backed by a 100-year legacy, CopperPoint is a specialty insurance company with deep expertise in Workers’ Compensation and a growing Property and Casualty offering. Now we are expanding into the Southeast with a brand-new presence in Alpharetta, Georgia, and this is your chance to help shape it from the ground up. At our core is a simple belief that has guided us for a century: people taking care of people.

We have an exciting opportunity for a Sr. Adjuster-Workers Comp Claims. In this role, you will leverage your knowledge and experience handling workers’ compensation claims across Georgia, Florida, North Carolina, and South Carolina to analyze time-loss claims and determine compensability. You will adjudicate claims to ensure timely and accurate payment of indemnity and medical benefits in accordance with company standards and regulatory requirements, while establishing and maintaining action plans and reserves to support proactive, cost-effective claims management. Candidates residing within 50 miles of our Georgia office will work in a hybrid environment.

Job responsibilities

• Analyze and investigate indemnity claims to determine compensability decisions by interpreting and applying laws, rules, and regulations of workers’ compensation.


• Utilize all available resources as appropriate.


• Build and maintain professional relationships with injured workers, policy holders, brokers and agents through proactive claim management and timely communications.


• Appropriately document communications and claim management activities.


• Develop, maintain and adhere to action plans and reserves on indemnity claims while proactively managing claims to resolution.


• Establish and maintain cost drivers and data elements to ensure accurate NCCI and Medicare reporting.


• Proactively manage claims in accordance with company standards and statutory requirements.


• Ensure timely payment of indemnity and medical benefits.


• Actively utilize all available cost containment measures and programs.


• Identify settlement opportunities. Negotiate settlements with claimants and attorneys.


• Conduct dispute resolution with claimants and attorneys. Testify at hearings when necessary.

Qualifications/Competencies

• Bachelor's degree (B.S. or B.A.) in business administration, communications, or a related field from an accredited four-year college or university is preferred.


• This is not an entry-level position; all candidates must have at least three years of prior experience handling or adjusting workers’ compensation claims.


• Must have prior WC claims handling experience. The ideal candidate will have WC claims handling experience in all our targeted states of FL, GA, NC, SC, and will also have expertise for other eastern jurisdictions.


• Excellent customer service skills, including initiative, mature judgment and discretion.


• Strong technical workers’ compensation knowledge with prior successful experience in workers’ compensation and other commercial lines claims management environments.


• Knowledge of Department of Insurance (DOI), NCCI, Department of Labor and Employment (CDLE) rules and regulations.


• Ability to analyze, interpret and apply laws, rules and regulations pertaining to workers’ compensation.


• Ability to stay current with changes to statutory and industry rules and regulations, as well as company policies and procedures that may impact claims management.


• Ability to set priorities, manage time, organize work and meet deadlines.

Benefits

• Employees and their families are eligible to participate in CopperPoint Insurance Companies benefit plans including medical, dental, vision, short-term disability, long-term disability, life insurance, a health savings account, a flexible spending account, and a 401k plan.


• We provide some benefits at no cost to the employee (Basic Life Insurance and AD&D at two times an employee’s annual salary, Short- and Long-term Disability coverage, and Employee Assistant Plan).


• Employees will accrue 0.0769 hours of Paid Time Off (PTO) per paid hour, which may total 20 days a year. In addition, employees will also receive 10 paid holidays throughout the calendar year.

Founded in 1925, CopperPoint Insurance Companies is a leading provider of workers’ compensation and commercial insurance solutions. With an expanded Line of insurance products and a growing ten-state footprint in the western United States, CopperPoint embodies stability for policyholders in Alaska, Arizona, California, Colorado, Idaho, Nevada, New Mexico, Oregon, Utah, and Washington. CopperPoint Mutual Insurance Holding Company is the corporate parent of Arizona-based CopperPoint Insurance Companies, Alaska National Insurance Company, and other CopperPoint Insurance Entities.

CopperPoint’s culture of compassion extends to the community through employee volunteerism, corporate matching, Board service, program sponsorships, and in-kind contributions. We empower employees by providing 12 hours of paid volunteer time annually and matching their personal contributions to the charities of their choice up to $500 per year. In 2020, CopperPoint employees reported 3,500 volunteer hours.

CopperPoint offers a competitive compensation package and comprehensive benefits package including major medical, dental, and vision and a wide range of competitive benefits programs, generous matching contributions to your 401(k) plan, generous paid time off, tuition reimbursement, and other education benefits and business casual dress. CopperPoint is an equal employment opportunity employer. All qualified applicants will receive consideration without regard to race, color, sex, religion, age, national origin, disability, veteran status, sexual orientation, gender identity or expression, marital status, ancestry or citizenship status, genetic information, pregnancy status, or any other characteristic protected by state, federal or local law. CopperPoint maintains a drug‑free workplace.