Sr. Workers Compensation Adjuster - REMOTE

Tower Legal Solutions; United States; On-site; USD 90,000 - 120,000; Full time

Job summary

Tower Legal Solutions seeks a Senior Workers Compensation Adjuster to manage moderate to high-value casualty claims with minimal supervision. You will conduct thorough investigations, assess coverage, and communicate clearly with legal counsel and experts to resolve disputes.

Key tasks include reserving, negotiating, and coordinating with internal and external stakeholders while maintaining strict regulatory compliance and data protection standards.

Qualifications

• Bachelor’s degree preferred or combination of education and equivalent experience.
• 5–10+ years of workers compensation claims handling experience with an insurance carrier.
• Must possess or obtain and maintain appropriate state adjuster licenses and continuing education credits.
• Skilled in negotiating complex claims and developing strategies to influence outcomes in high-exposure cases (including litigation and compliance).
• Clear and effective communication in verbal and written formats across situations; empathic toward stakeholders.
• Highly organized with ability to manage complex workflows and mentor others in these areas.
• In-depth understanding of regulatory environment and jurisdictional requirements.
• Provides exceptional, empathetic customer service and handles escalated claims professionally.
• Ability to work on-site, sit/stand for extended periods and travel as needed.

Responsibilities

• Independently manage moderate to complex, high-value casualty claims with thorough analysis and resolution.
• Lead investigations, assess coverage, and issue reservation of rights and coverage letters; escalate as needed.
• Identify opportunities for subrogation and negotiate to optimal outcomes, including litigation management.
• Ensure all claims activities comply with regulatory and company standards; maintain detailed records and reports.
• Set reserves, authorize payments, and make financial decisions within authority.
• Coordinate with legal, underwriting, vendors, and agents; lead cross-functional meetings.
• Use analytics to identify trends, improve handling efficiency, and protect PII.
• Mentor junior claim handlers and contribute to training and best practices.

Skills

Negotiation

Investigation

Regulatory knowledge

Communication

Mentoring

Project management

Data analysis

Customer service

Education

Bachelor’s degree preferred

Job description

Please note that all applicants must have previous carrier experience to be considered. Third Party Administrator experience will not qualify as sufficient to qualify applicants for this role.

The Senior Workers Compensation Adjuster is responsible for managing moderate to complex and high-value casualty claims with minimal supervision. This role requires advanced investigative and negotiation skills to effectively resolve disputes and handle escalated situations. The Consultant works closely with internal and external experts, including legal counsel and technical specialists, to ensure thorough claim evaluation and resolution.

Key responsibilities include representing the company in various forums related to claims litigation, maintaining a high standard of professionalism, and ensuring compliance with regulatory and company standards. The role demands strategic thinking, sound judgment, and the ability to navigate sensitive and high-impact claim scenarios.

IN THIS ROLE, YOU WILL:

• Independently manage moderate to complex, high-value casualty claims, ensuring thorough analysis and resolution. Lead thorough investigations, assess coverage, and issue appropriate documentation including reservation of rights and coverage letters. Escalate issues as needed.
• Identify opportunities to transfer risk and pursue subrogation. Proactively resolve disputes, deescalate sensitive situations, and ensure optimal claim outcomes through strategic negotiation and litigation management.
• Ensure all claims activities comply with regulatory and company standards. Maintain accurate, detailed records and prepare comprehensive reports. Execute jurisdictional compliance requirements and support others in understanding regulatory obligations.
• Set reserves, authorize payments, and make financial decisions within authority. Demonstrate strong financial acumen and contribute to reserving accuracy and efficiency.
• Coordinate with internal and external stakeholders including legal, underwriting, vendors, and agents. Lead cross-functional meetings and communicate complex information clearly to diverse audiences.
• Use advanced tools and analytics to identify trends, correct inconsistencies, and improve claims handling efficiency. Ensure proper data ingestion, labeling, and protection of personally identifiable information (PII).
• Serve as a mentor to junior claim handlers, providing guidance on complex claims, compliance, and litigation processes. Support training initiatives and contribute to the development of best practices and educational materials.

WHAT YOU NEED TO APPLY:

• Bachelor’s degree preferred, or a combination of education and equivalent experience.
• 5–10+ years of workers compensation claims handling experience with an insurance carrier.
• Must possess or obtain and maintain appropriate state adjuster licenses and continuing education credits.
• Skilled in negotiating complex claims and developing strategies to influence outcomes. Demonstrates sound judgment and decision-making on high-exposure cases, including litigation and compliance matters.
• Communicates clearly and effectively in both verbal and written formats across a variety of situations. Selects appropriate communication channels and consistently demonstrates empathy toward all stakeholders.
• Highly organized with the ability to manage complex workflows and participate in project work. Demonstrates strong time management and desk management skills, and mentors others in these areas.
• Possesses in-depth understanding of the regulatory environment and jurisdictional requirements. Handles complex compliance issues and mentors others on regulatory standards.
• Provides exceptional, empathetic customer service. Effectively manages escalated claims and sensitive customer concerns with professionalism and clarity.
• Ability to use a personal computer and other standard office equipment.
• Ability to sit and/or stand for extended periods.
• Required to work on-site as needed.
• Ability to travel as necessary.
• Ability to work in a fast paced, changing or stressful environment.
• Ability to perform work in a noisy/loud work environment.
• May be required to have and maintain sufficient home-based internet connection.