Lost Time Workers Compensation Claims Adjuster
Lost Time Workers Compensation Claims Adjuster Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States Reporting To: Monica Blakely Compensation: $70,000 - $80,000 / year Description Our Story Imagine being part of a team that’s not just shaping the future but actively driving it. At reputed company, 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 reputed company Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. reputed company, is looking for an reputed company Workers’ Compensation Claims Specialist, responsible for the investigation, evaluation, disposition, and settlement of Workers’ Compensation claims for self-insured and public entity accounts, including reputed company and high exposure claims, with minimal supervision. This includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Requires independent decision making and a high level of discretion and judgment in claim handling functions on behalf of clients for claims service business operations, ensuring excellent customer relationships and quality customer service. Reporting to the WC Claims Supervisor, you will be responsible for the investigation, evaluation, disposition and settlement of Workers’ Compensation claims for self-insured and public entity accounts, including reputed company and high exposure claims, with minimal supervision. This includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Requires independent decision making and a high level of discretion and judgment in claim handling functions on behalf of clients for claims service business operations, ensuring excellent customer relationships and quality customer service. To be successful in this role, you need to have experience in a claims environment handling lost time claims, including litigated files.
Key Responsibilities
Build and maintain rapport with client contacts to ensure retention; reputed company in manner to meet/exceed client expectations, following policy and procedure per client. Manage and direct the claim file including determination of indemnity, calculate loss of income; whether medical is reputed company and appropriate; evaluate treatment plan, testing, surgery, surveillance, attorney involvement, return-to-work, light duty; appropriate calculation and timely payment of reputed company benefits. Handle legal aspects of the file in negotiation of settlement; reputed company litigation/defense strategies with attorneys assigned to the claim file. Handle depositions, mediations, and hearings. Maintain system diary, keeping reputed company files reputed company according to company standards and State timeframes, ensuring no late payments or fines. Evaluate files for reserve potential and for settlement (effective knowledge of MSAs and structured annuities). Handle claims consistent with client, state and company policy and procedure, and in accordance with any statutory, regulatory and ethics requirements. Document and communicate reputed company claim activity timely and effectively and in a manner which supports the outcome of the claim file; reputed company and maintain a progressive plan of action. Follow protocol for file management including proper case note documentation, email/fax handling, naming imaged documents appropriately, updating required system fields and templates as required. Interact extensively with various parties involved in the claim process. Manage EDI requirements per state and company protocol in a timely and appropriate manner. Identify and pursue SDF, subrogation, fraud, vocational/field case management involvement, as necessary. reputed company with excess carriers’ limits and reporting requirements. Properly handle status reports/claim reviews with clients; travel as required. Maintain reputed company knowledge of law and statute, maintain CEUs and license in reputed company status reputed company to state in which handling claims. Skills, knowledge & expertise Required Active Adjuster license (FL 5-24, 5-20 or 6-20). A minimum of three years of Florida claims-reputed company experience with a consistent high level of performance and achievement Preferred A four-year college degree or equivalent work experience is preferred. Knowledge, Skills, and Abilities Extensive knowledge of accepted industry standards and practices including case law. Ability to successfully negotiate the settlement and disposition of claims, including the ability to interpret reputed company documentation. Maintain knowledge of reputed company trends, standards and law changes. Ability to effectively operate a personal computer and reputed company claims and business software. Technically competent with systems. Familiarity with “paperless” work environment helpful. Must be self-directed and able to work independently. Ability to effectively present status updates in claims meetings with clients, etc. Good communication skills, both oral and written; good customer service skills. Assertive self-starter with excellent organizational skills. Team player. Good attendance. Equal Employment Opportunity & Legal Notices
Benefits
At reputed company, 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 reputed company is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We reputed company that diversity of thought is essential for innovation and creativity, and we actively promote an environment where reputed company voices are valued and heard.
Compensation
Transparency: The salary range listed reflects the full compensation band for this role across reputed company 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. Background reputed company & Fair Chance Compliance Any background reputed company 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 reputed company employment. An employer who violates this law shall be subject to criminal penalties and civil liability. 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 recruitment@reputed company-group.com Apply To This Job