Workers' Compensation Medical Only Adjuster (Remote)

Davies; Florida; Hybrid; USD 46,000 - 50,000; Full time

Job summary

Davies North America is seeking a remote Workers' Compensation Medical Only Claims Adjuster licensed in FL to manage indemnity and medical-only claims from intake to resolution. The role requires strong technical expertise, sound judgment, and proactive claim strategies in a national remote setting.

Responsibilities include adjudication, investigation, medical/indemnity management, and coordinating with defense counsel on litigated matters, while ensuring compliance with jurisdictional

Qualifications

• 3+ years of Workers' Compensation claims handling experience.
• Active and valid FL license (5-20 or 6-20).
• Experience with medical-only Workers' Compensation claim portfolios preferred.
• Independently handles claims of moderate complexity.
• Strong negotiation, reserving and file direction skills.

Responsibilities

• Manage Workers' Compensation claims from intake through closure
• Determine compensability and benefit eligibility
• Establish and adjust reserves based on claim exposure
• Conduct investigations, including interviews and documentation review
• Develop and execute claim strategies
• Identify opportunities for early resolution
• Monitor treatment plans and coordinate return-to-work efforts
• Administer indemnity benefits in compliance with jurisdictional requirements
• Coordinate with defense counsel on litigated claims
• Provide timely updates to clients and stakeholders
• Ensure compliance with state regulations and internal standards

Skills

Workers' Compensation claims

FL license

Medical-only claims

Claim adjudication

Return-to-work coordination

Job description

Workers' Compensation Medical Only Adjuster (Remote)

Department: Claims Administration & Adjusting

Employment Type: Permanent - Full Time

Location: Home United States

Reporting To: Supervisor WC TPA

Compensation: $45,500 - $50,050 / year

Description

Our Story

Imagine being part of a team that isn't just shaping the future but actively driving it. At Davies North America, we're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

What's in Store

We're seeking a Workers' Compensation Medical Only Claims Adjuster who brings strong technical expertise, sound judgment, and a proactive approach to managing indemnity and medical-only claims. You must be licensed in FL to handle workers' compensation claims.

This role manages Workers' Compensation claims from intake through resolution and support medical-onlyclaim types. The adjuster investigates, evaluates, and manages claims in accordance with company guidelines, client expectations, and jurisdictional requirements.

Key Responsibilities

Claim Ownership & Adjudication

• Manage Workers' Compensation claims from intake through closure
• Determine compensability and benefit eligibility
• Establish and adjust reserves based on claim exposure

Investigation & Case Management

• Conduct investigations, including interviews and documentation review
• Develop and execute claim strategies
• Identify opportunities for early resolution

Medical & Indemnity Management

• Monitor treatment plans and coordinate return-to-work efforts
• Administer indemnity benefits in compliance with jurisdictional requirements

Litigation Management

• Coordinate with defense counsel on litigated claims
• Support hearings, mediations, and settlements
• Client Communication & Compliance
• Provide timely updates to clients and stakeholders
• Ensure compliance with all state regulations and internal standards

Skills, knowledge & expertise

• 3+ years of Workers' Compensation claims handling experience
• Must have an active and valid license in FL (5-20 or 6-20)
• Experience with medical-only Workers' Compensation claim portfolios preferred
• Independently handles Workers' Compensation claims of moderate complexity
• Determines compensability, conducts investigations, evaluates exposure, and establishes appropriate reserves
• Manages claim strategy, treatment progression, indemnity administration, and return-to-work coordination
• Handles some litigated matters and applies sound judgment in negotiations, reserving, and file direction
• Maintains compliance with jurisdictional requirements, client service expectations, and internal standards

Equal Employment Opportunity & Legal Notices

Benefits

At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and vision plans to support your health and that of your family
• A 401(k) plan with employer matching
• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees
• Paid holidays
• Life insurance and short-term and long-term disability coverage

Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee's primary work location.

Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.

Diversity and Inclusion

Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

Compensation Transparency:

The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.

Essential Functions

• Maintain regular and dependable attendance.
• Be available and able to perform job responsibilities during established work hours.

Background Check & Fair Chance Compliance

Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair-chance hiring requirements.

Massachusetts Notice

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

AI Policy

At Davies, we value authentic conversations and a fair candidate experience. While candidates may use AI and technology tools to prepare for interviews, we expect interview responses and assessments to reflect each individual's own experience, knowledge, and professional judgment.

We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at [e-mail]