Workers' Compensation Adjuster (Louisiana - Remote)

We are seeking a Louisiana Workers’ Compensation Claims Adjuster to investigate, evaluate, and manage Workers’ Compensation claims while delivering timely, cost-effective resolutions and exceptional client service.

Key Responsibilities

• Own the full lifecycle of Workers’ Compensation claims, from initial investigation through resolution.
• Determine compensability and coverage with confidence and accuracy.
• Conduct detailed investigations, including interviews and evidence gathering.
• Analyze medical, legal, and employment documentation to guide decision-making.
• Manage EDI reporting and ensure CMS Section 111 compliance.
• Develop and execute strategic claim plans for complex and litigated files.
• Partner with defense counsel to drive effective litigation strategies and control costs.
• Negotiate settlements with claimants and attorneys to achieve optimal outcomes.
• Handle catastrophic and high-severity claims with care and precision.
• Leverage preferred vendors and cost-containment tools effectively.
• Deliver clear, insightful reporting to clients and excess carriers.
• Maintain strong client relationships through responsive, professional communication.
• Stay current on jurisdictional requirements, trends, and best practices.
• Support team development through mentorship and knowledge sharing.
• Independently handle Workers’ Compensation claims of moderate complexity, including medical-only and lost time files.
• Conduct investigations, determine compensability, evaluate exposure, and establish appropriate reserves.
• Manage claim strategy, medical and legal developments, and resolution planning with increasing independence.
• Handle some litigated matters and apply sound judgment in negotiations, reserving, and file direction.
• Maintain compliance with jurisdictional requirements and client service expectations.

Skills, Knowledge & Expertise

• 3+ years of Workers’ Compensation claims handling experience.
• Experience with lost time claims, compensability analysis, and claim strategy preferred.
• Active adjuster licenses as required by Louisiana (or ability to obtain).
• Direct experience handling Louisiana Workers’ Compensation claims (level-dependent).
• Knowledge of Louisiana Workers’ Compensation laws and jurisdictional requirements.
• Understanding of medical terminology and its impact on claim exposure.
• Strong investigation, analysis, and decision-making skills.
• Effective negotiation and communication abilities.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency with claims systems and related technology.
• Professionalism in handling sensitive or confidential information.

Benefits

• 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.