Description
We're seeking a Workers' Compensation Medical Only Claims Adjuster to manage claims from intake through resolution. You'll 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
- Active FL license
- Experience with medical-only, lost time, or blended Workers' Compensation claim portfolios preferred
- 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
Benefits
- Medical, dental, and vision plans
- 401(k) plan with employer matching
- Time-off policies, including Discretionary Time Off (DTO) and Paid Time Off (PTO)
- Paid holidays
- Life insurance and short-term and long-term disability coverage