Description
We’re seeking a Workers’ Compensation Lost Time Adjuster who brings strong technical expertise, sound judgment, and a proactive approach to managing indemnity and medical-only claims.
As the Workers' Compensation Lost Time Adjuster, you will investigate, evaluate, and manage 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
- Experience with medical-only, lost time, or blended Workers’ Compensation claim portfolios preferred
- Must have active FL-license (6-20 or 5-20)
- Must have presumption experience
- Must be located in Eastern Time Zone and be able to work M-F, 8am - 5pm.
- Strong knowledge of Workers’ Compensation laws, benefit structures, and claims processes
- Experience managing indemnity payments and return-to-work programs
- Ability to handle multiple claims in a fast-paced environment
- Strong investigative, analytical, and decision-making skills
- Effective negotiation and problem-solving abilities
- Excellent written and verbal communication skills
- Proficiency with claims management systems and related technology
- Active adjuster license(s) or ability to obtain as required
Preferred
- Experience with EDI reporting and jurisdictional compliance requirements
- Familiarity with nurse case management and medical cost containment strategies
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