Workers Compensation Adjuster – New York

Questpro Consultants LLC; New York (NY); Remote; USD 65,000 - 95,000; Full time

Job summary

Questpro Consultants LLC is partnering with a leading claims-management firm to hire an experienced Workers' Compensation Adjuster for New York claims (license required). This remote role favors NY residents but accepts nearby states.

Responsibilities include evaluating claims, administering end-to-end processes, negotiating settlements, maintaining precise files, and collaborating with claimants, counsel, and medical professionals to reach the best resolutions.

Qualifications

• Bachelor's degree or equivalent experience in insurance or claims management.
• 3 years of workers' compensation claims adjusting experience.
• Strong analytical skills and data-informed judgment.
• Excellent communication and interpersonal skills — assertive, empathetic, and diplomatic.
• Proficiency with claims management software and Microsoft Office.

Responsibilities

• Evaluate claims: Conduct thorough investigations and deliver well-supported claim determinations.
• Administer processes: Manage claims end-to-end in compliance with jurisdictional guidelines and internal protocols.
• Negotiate resolutions: Drive negotiations with claimants, attorneys, and physicians to settle claims cost-effectively.
• Document with precision: Maintain complete, current, and accurate claim files.
• Advocate for stakeholders: Partner with clients, counsel, and medical professionals to reach the best resolution.
• Analyze trends: Identify and report emerging claim trends to improve process and service quality.

Skills

Analytical skills

Communication

Interpersonal skills

Data-informed judgment

Education

Bachelor's degree or equivalent in insurance/claims management

Tools

Claims management software

Microsoft Office

Job description

Workers' Compensation Adjuster

Questpro has partnered with a well-established leader in claims management to find an experienced in Indemnity desk plus litigation Workers' Compensation Adjuster handling New York claims (License Required). Our preference is someone with experience working for or at a TPA. Our client is redefining how risk is managed and claims are handled, and this role sits at the center of that work - every claim tells a story, and you'll be the voice behind it. This is a remote role, ideally in NY but open to surrounding states as well.

Performance Objectives

• Evaluate claims: Conduct thorough investigations and deliver well-supported claim determinations.
• Administer processes: Manage claims end-to-end in compliance with jurisdictional guidelines and internal protocols.
• Negotiate resolutions: Drive negotiations with claimants, attorneys, and physicians to settle claims cost-effectively.
• Document with precision: Maintain complete, current, and accurate claim files.
• Advocate for stakeholders: Partner with clients, counsel, and medical professionals to reach the best resolution.
• Analyze trends: Identify and report emerging claim trends to improve process and service quality.

Environment & Resources

• Collaborative, innovative team with mentorship and clear professional growth paths.
• Advanced claims management software and tools.
• Reports directly to the Claims Supervisor.

Essential Qualifications

• Bachelor's degree or equivalent experience in insurance or claims management.
• 3 years of workers' compensation claims adjusting experience.
• Strong analytical skills and sound, data-informed judgment.
• Excellent communication and interpersonal skills - assertive, empathetic, and diplomatic.
• Proficiency with claims management software and Microsoft Office.

Why This Role

• Join a recognized industry leader in risk management services.
• A culture that values diversity, creative thinking, and professional development.
• Broad claim exposure that builds deep risk assessment and negotiation skills.
• On-the-job training designed to accelerate career advancement.