Description
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 will manage Workers’ Compensation claims from intake through resolution and support medical-only claim 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
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