TPA Claims Specialist – Workers’ Comp Expert

USI Insurance Services; Burlington (MA); On-site; USD 57,000 - 77,000; Full time

Job summary

USI Insurance Services seeks an experienced adjuster to manage workers' compensation claims, including lost and non-lost time cases. You will apply in-depth knowledge of claims processes, communicate with clients, carriers, and claimants, and support negotiations and resolutions.

The role requires at least 5 years in claims adjusting, a strong analytical mindset, and a collaborative approach within a team environment. Licenses in applicable jurisdictions are required.

Qualifications

• Minimum 5 years of claims adjusting experience.
• College degree preferred but high school diploma or GED acceptable.
• Proficient to expert in MS Office suite.
• Must be licensed in all jurisdictions handled.
• Strong written and verbal communication skills.
• Ability to work well in a team environment.
• Strong analytical thinking and problem-solving skills.
• Strong organizational and negotiation abilities.

Responsibilities

• Adjust lost and non-lost time workers' compensation claims.
• Communicate effectively with internal and external customers.
• Apply knowledge of workers' compensation strategies and adjusting practices.
• Enter first reports of injury and adjust claims in the systems.
• Participate in claim advocacy, negotiations, and settlements.
• Review and approve loss time medical services and expenses.
• Plan and attend claim reviews with clients, carriers and auditors.
• Identify client issues and drive resolution plans.
• Analyze claims per policy and procedures.

Skills

Claims adjusting

Communication

Workers' comp knowledge

Negotiation skills

Analytical thinking

Team player

MS Office

Education

College degree preferred

Tools

MS Office

Job description

USI Insurance Services seeks an experienced adjuster to manage workers' compensation claims, including lost and non-lost time cases. You will apply in-depth knowledge of claims processes, communicate with clients, carriers, and claimants, and support negotiations and resolutions.

The role requires at least 5 years in claims adjusting, a strong analytical mindset, and a collaborative approach within a team environment. Licenses in applicable jurisdictions are required.