Sr. Claims Adjuster - Workers Compensation

Role: Senior Claims Adjuster - Workers' Compensation

Location: Remote

Duration: 3-month contract-to-potential hire

Pending Caseload: Approximately 150-180 workers' compensation claims

Pay: $43.71/hr

Job Description

The Senior Resolution Manager is responsible for handling complex workers' compensation claims through investigation, evaluation, litigation management, and resolution. This individual will manage a high-volume caseload while partnering with employers, injured workers, attorneys, medical providers, and insurance partners. The ideal candidate will have strong workers' compensation experience, excellent claim judgment, and the ability to independently manage complex and litigated claims across multiple clients.

Required Qualifications

• 5-7+ years of workers' compensation claims experience
• Experience managing indemnity and lost-time claims
• Ability to independently manage a high-volume caseload
• Experience handling claims across multiple clients
• Strong understanding of compensability and state workers' compensation regulations
• Excellent investigation and claim resolution skills
• Comfortable working in a TPA environment
• Ability to learn and utilize claims management systems

Midwest/California Requirement (Must Have)

Experience and/or active licensing in several of the following states:

• Illinois
• Wisconsin
• Michigan
• Minnesota
• Iowa
• South Dakota
• California

Preferred Qualifications

• Litigation management experience
• TPA experience (Gallagher Bassett, Sedgwick, Broadspire, CorVel, ESIS, CCMSI, Charles Taylor, PMA, Cannon Cochran, Helmsman, etc.)
• Captive insurance program experience
• Multi-state workers' compensation claims handling experience
• Self-insured account experience

Responsibilities

• Manage a portfolio of workers' compensation claims from assignment through closure
• Investigate claims and determine compensability
• Review medical records, wage information, and treatment plans
• Coordinate return-to-work efforts
• Establish claim reserves and manage claim strategy
• Partner with attorneys on litigated files
• Negotiate settlements and claim resolutions
• Maintain diary compliance and claim documentation
• Communicate regularly with employers, claimants, and insurance partners
• Effectively manage claims across multiple clients while meeting service standards