Workers' Compensation Adjuster II

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

Job Description

Job Description

Workers’ Compensation Adjuster II

We are growing! Claims Resolution Corporation, Inc., located in Egg Harbor Township, New Jersey,

is a full-service, multi-line claims management provider, including Workers’ Compensation, General Liability, Auto Liability, Professional, and Property claims administration services. Our client-focused, ethical, and relationship-based team members are the heart of our vision to be the best third-party administrator (TPA.

If you are eager to collaborate within a diverse team, embrace challenges, and continue to develop your skills, then Claims Resolution Corporation, Inc. may be the place for you. We offer a career-oriented environment that values your contributions and encourages you to grow.Remote, hybrid, and in-person work options for candidates in NJ, PA, and DE.

Position Summary:

This mid-level position is responsible for managing a caseload of complex medical treatment claims involving lost time, multiple body part injuries, and litigation in New Jersey and /or Pennsylvania. The analyst Independently manages the investigation, evaluation, and resolution of workers’ compensation claims in compliance with legal statutes, policy terms, and client-specific instructions. The analyst coordinates medical care, negotiates settlements, and works closely with claimants, clients, attorneys, and medical professionals to achieve timely, cost-effective outcomes. This role also serves as a technical resource and advocate for client claim concerns. This position is ideally in-person or hybrid; however, a remote work option may be considered for candidates residing in NJ, PA, or DE.

Key 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.

Qualifications:

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

Physical Requirements:

Prolonged periods of sitting and computer work.

Employee Benefits:

• Paid time offMedical, dental, and vision insurance401(k)HRA & FSAGroup life, STD, and LTD insurance, and more!

Claims Resolution Corporation, Inc. is an Equal Opportunity Employer, providing employment opportunities to all qualified individuals regardless of race, creed, color, sex, sexual orientation, religion, national origin, age, disability, or any other basis prohibited by law.

This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.