CA - Claims Adjuster, Workers Compensation
Core
Manage workers' compensation claims from setup to closure, conducting investigations, determining compensability, setting reserves, and negotiating settlements to mitigate exposure.
Role type
Senior IC claims adjuster (workers' compensation)
Builds
Favorable claim outcomes and efficient claim file management for small business customers
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
workers' compensation claims adjudication, claim investigation, reserve setting, litigation management, medical management, settlement negotiation, regulatory compliance, claim status reporting
Preferred skills
G-Suite tools, Slack, CMS/MSA requirements knowledge, AI application review tools
Responsibilities
Conduct 3-point contact investigations, determine compensability decisions, set and adjust reserves, administer medical and indemnity benefits, control legal activity and fees, negotiate settlements, serve as point of contact for agents and customers, improve claims operations and SOPs
Seniority
Mid-level, hands-on IC
