Workers' Compensation Specialist

Davies Talent Solutions; United States; Remote; USD 110,000 - 150,000; Full time

Job summary

An established industry player is on the lookout for experienced Senior Workers’ Compensation Claims Adjusters for a short-term remote project. This role demands extensive indemnity claims experience, strong judgment, and meticulous attention to detail. You will be responsible for reviewing claims, ensuring documentation accuracy, and correcting inconsistencies across systems. If you thrive in independent settings and are passionate about making a difference in claims management, this opportunity offers a chance to showcase your skills while contributing to a critical project. Join a forward-thinking team and take your career to the next level!

Qualifications

• 5+ years of experience in handling Workers’ Compensation indemnity claims.
• Proficient with claims management systems and documentation standards.

Responsibilities

• Review and confirm accurate limb identification backup documentation.
• Correct inconsistencies in limb coding or descriptions.
• Ensure claims are coded correctly as Open, Closed, Pending Litigation, or Denied.

Skills

Workers’ Compensation Indemnity Claims Handling

Claims Audits

Documentation Standards

Independent Work

Organizational Skills

Communication Skills

Education

5+ years of experience in Workers’ Compensation

Tools

Claims Management Systems

Job description

Davies Group is seeking experienced Senior Workers’ Compensation Claims Adjusters for a short-term remote project. This assignment focuses on things like limb identification backups, paper backups, formatting adjustments, and claims review/reconciliation across two different systems. This project requires extensive indemnity claims experience, strong judgment, attention to detail, and the ability to operate independently with minimal supervision.

Key Responsibilities:

• Review previously audited WC claims and confirm accurate limb identification backup documentation.
• Verifying the correct documentation of injured body parts across different records and notes.
• Ensuring limb injuries match official claim documents and medical reports.
• Correcting inconsistencies in limb coding or descriptions.
• Cross-referencing scanned documents with system entries to ensure paper trail accuracy.
• Uploading missing physical documents to electronic claims files.
• Labeling, indexing, and organizing backup paperwork to match digital file structures.
• Cleaning up narrative notes for clarity and standard formatting.
• Updating document naming conventions and date stamping to match system standards.
• Correcting formatting inconsistencies between two systems (titles, dates, injured party names).
• Comparing claims in System A vs. System B and identifying mismatches
• Manually correcting errors and updating statuses across both platforms.
• Double-checking wage statements, indemnity rates, and benefit payments.
• Verifying past payments made under indemnity (e.g., Temporary Total Disability, Permanent Impairment).
• Ensuring claims are coded correctly as Open, Closed, Pending Litigation, or Denied.
• Adjusting claim statuses to reflect accurate lifecycle stages if discrepancies exist.
• Creating missing audit summaries or backup forms where necessary.
• Rebuilding paper files into acceptable audit-ready formats.
• Removing duplicate notes, documents, or claims entries.
• Flagging incomplete files for follow-up or supervisor review.
• Consolidating claims notes into clearer summary documents when needed.
• Determining when missing information requires escalation vs. self-resolution.
• Using experience to prioritize critical errors vs. minor formatting issues.
• Ensuring all required forms (DWC forms, Notice of Injury, First Report of Injury, etc.) are properly documented and attached.
• Making sure benefit notices and state-mandated forms were correctly sent and recorded.

Required Qualifications:

• Minimum 5+ years of Workers’ Compensation indemnity claims handling experience.
• Experience with claims audits, system crosswalks, or file review projects preferred.
• Strong understanding of indemnity calculations and documentation standards.
• Ability to work independently and meet strict project deadlines.
• Proficient with claims management systems (experience in two systems a plus).
• Excellent organizational, written, and communication skills.
• Must have high-speed internet and a secure home office setup.

Nice to Have:

• Experience working for a Third-Party Administrator (TPA) or large carrier.
• Previous project-based claims clean-up or audit work.
• Multi-state WC claims experience, especially Florida, Texas, or New York.
• Licensed in any state
• Potential overtime available based on project needs
• Training and project guidance provided remotely

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Contract

Job function

• Job function

  Human Resources

• Industries

  Insurance

Referrals increase your chances of interviewing at Davies Talent Solutions by 2x

Sign in to set job alerts for “Workers' Compensation Specialist” roles.

California, United States $45.00-$50.00 6 days ago

Workers Compensation Claims Specialist - Remote

Senior Workers Compensation Claims Specialist

MANAGEMENT ASSISTANT 1539 C (REVISED 02-10-2023)

Waukee, IA $57,000.00-$98,000.00 2 weeks ago

United States $110,000.00-$150,000.00 1 day ago

Austin, Texas Metropolitan Area 6 days ago

Remote Junior Credentialing Specialist (Credentialing Data Entry and Analysis)

Correspondence Processor - Remote ( Must work PST hours)

Correspondence Processor - Remote ( Must work PST hours)

Correspondence Processor - Remote ( Must work PST hours)

United States $1,500.00-$3,800.00 2 months ago

Correspondence Processor - Remote ( Must work PST hours)

Correspondence Processor - Remote ( Must work PST hours)

Correspondence Processor - Remote ( Must work PST hours)

Workers’ Compensation Collections Specialist (Remote – TX Based)

Texas, United States $16.00-$21.00 3 months ago

Correspondence Processor - Remote ( Must work PST hours)

Credentials Examiner I (Remote, $16/hour)

Correspondence Processor - Remote ( Must work PST hours)

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.