Worker’s Compensation Claims Adjuster 2
Industrial Commission of Arizona (ICA) – Claims Division
800 W. Washington Street, Phoenix, AZ
Job Overview
This role combines high‑level claims investigation and statutory oversight, focusing on complex determinations and the regulatory enforcement of bad faith and unfair claims processing pursuant to ARS 23‑930 and AAC R20‑5‑163. The Adjuster investigates, evaluates, and analyzes complex Workers’ Compensation situations and serves as the primary lead for the Bad Faith/Unfair Claims Processing Program, managing internal and externally filed complaints through to resolution. The position may offer remote work within Arizona based on business needs and performance outcomes.
Salary / Grade / Closing Date
Salary: $65,000 – $70,000
Grade: 20
Closing Date: June 30, 2026
Job Duties
- Identify, review, and process all requests for 1061M, internal and external complaints regarding bad faith or unfair claims practices; manage the escalated dispute process to completion, conduct audits, analyze trends, and compile formal reports for leadership.
- Track payer claim status using Salesforce and other reporting software, make lifetime award determinations, calculate average monthly wages or loss‑of‑earnings awards, and enforce compliance efforts.
- Conduct audits and complex research to proactively identify compliance issues; make recommendations and develop internal and external programs to increase quality and compliance with Arizona WC laws, rules, and statutes.
- Provide training to internal and external customers, technical advice, guidance, and troubleshooting support regarding complex claim issues.
- Support the annual Claims Seminar by updating the Claims Manual and presenting dynamic presentations to community members.
- Provide back‑up assistance to awards, compliance, customer service, wage, data entry, no match, or insurance functions as requested.
Knowledge, Skills & Abilities (KSAs)
- Comprehensive knowledge of Title 23, Chapter 6 of the ARS (Arizona Workers’ Compensation Act).
- Knowledge of Industrial Commission of Arizona Claims Division operations and claims adjusting practices.
- Excellent knowledge of Microsoft Office; proficiency in Google Suite and Salesforce is a plus.
- Basic business English and mathematics skills.
- Skill in strong writing, verbal communication, reasoning, analytical thinking, data interpretation, time management, initiative, attention to detail, organization, planning, customer service, and producing high‑quality error‑free output.
- Ability to learn computer systems and applications, use technology to problem‑solve, write technical instructions, interpret standard claim files, conduct research, manage a heavy workload with accuracy, work in a diverse and inclusive environment, process documents promptly, adapt to changing circumstances, exercise discretion and judgment, and handle pressure.
- Ability to perform job responsibilities incorporating lean management principles and the Arizona Management System; read and comprehend complex insurance, medical, and legal documents.
Selective Preferences
High School Diploma, Bachelor’s Degree, or substitute with 5+ years of Arizona Workers’ Compensation Claims Handling.
Pre‑Employment Requirements
All newly hired State employees must successfully complete the Electronic Employment Eligibility Verification Program (E‑Verify).
Benefits
- Sick leave
- Vacation with 10 paid holidays per year
- Paid Parental Leave – up to 12 weeks for a newborn or newly‑placed foster/adopted child
- Health and dental insurance
- Retirement plan (Arizona State Retirement System, ASRS)
- Life insurance and long‑term disability insurance
- Optional employee benefits: short‑term disability insurance, deferred compensation plans, supplemental life insurance
- Remote work option provided at the management’s discretion; remote agreements may be terminated at the agency’s discretion.
Additional Information
The Arizona Department of Administration offers a comprehensive benefits package, and employees participate in the state employee health/disability insurance plan. Contributions to the Arizona State Retirement System are matched by the employer.
Contact
For questions, call 602‑542‑5559 or email HR@azica.gov.