Complex Claims Adjuster
Core
Adjudicate catastrophic and large loss workers' compensation claims, managing investigations, reserves, litigation, and settlements to mitigate exposure and achieve favorable outcomes.
Role type
Senior IC complex claims adjuster (workers' compensation)
Builds
Closed claims with optimal financial and customer outcomes
Domain
Insurance / Workers' Compensation / Catastrophic Claims
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
catastrophic claim adjudication, workers' compensation law, reserve setting, litigation management, structured settlements, Medicare Set-Aside (MSA) administration, negotiation, claim investigation, regulatory compliance
Preferred skills
carrier background, Southeast region expertise (Florida/Georgia), G-Suite/Slack proficiency, mentoring junior adjusters
Technologies
G-Suite, Slack
Responsibilities
Conduct 3-point contact investigations for large loss claims; determine compensability and set/adjust reserves; manage legal activity and defense counsel; negotiate settlements and obtain settlement authority; attend mediations and trials; serve as point of contact for agents and insureds; present large loss updates to stakeholders; collaborate on process improvements.
Seniority
Senior, hands-on IC