117 workers compensation complex claims adjuster jobs found in Wilkes-Barre, PA

The salary range for this job posting is $55,132.00 - $110,642.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. The actual salary range for candidates who reside in Pennsylvania is $59,630 - 119,670 annually + bonus + benefits. Pay Type: Salary We strongly prefer candidates who reside in Pennsylvania however, will consider those who reside in any of our listed payroll approved states with the related experience. This role will manage Workers' Compensation Lost Time and Medical Only claims within multiple jurisdictions. However, experience managing Workers' Compensation claims in Pennsylvania is required. Experience with Delaware and...

Company Argo Group Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Business Title(s): TEMP - Workers’ Compensation Claims Adjuster Employment Type: Contingent Worker FLSA Status: Non-Exempt Location: In-Office or Remote   Summary: We are looking for a highly capable Workers’ Compensation Claims Adjuster to join our team and work from anywhere in the United States. The position reports to a manager based in Rockwood, PA and initially will be focused on adjudicating medical-only claims and indemnity claims, in the jurisdiction of MN.  In addition, this position manages both Federal and State Black Lung claims that have already been reviewed and a schedule of benefits approved by the...

Company Argo Group Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Business Title(s): TEMP - Senior Workers’ Compensation Claims Adjuster Employment Type: Contingent Worker FLSA Status: Non-Exempt Location: In-Office or Remote   Summary: We are looking for a highly capable Senior Workers' Compensation Claims Adjuster to help us on a temporary assignment with an estimated end date of October 9, 2026 and work from anywhere in the United States. This role will adjudicate indemnity workers' compensation claims of higher technical complexity for our customers in the states of SC and VA.   As this is a temporary assignment, only government mandated benefits will be provided.   Contractors...

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This role is available for both remote and hybrid work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost...

The Workers’ Compensation Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The WC Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This role is available for both remote and hybrid work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises WC claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial...

Overview AmTrust Financial Services, a  fast growing  commercial insurance company, has a need for a Complex Care Case Manager, RN for Workers Compensation managed care team.     PRIMARY PURPOSE :   The  complex care case manager will provide comprehensive and quality telephonic case management for our injured employees with complex diagnoses and often catastrophic injuries. Our nurses will  be responsible for  proactively applying clinical  expertise  ensuring our injured employees receive medically  appropriate healthcare  to achieve a safe return to work or best  optimal  level of function through engagement with the injured employee,  provider  and employer. Our nurses will be empathetic informative medical resources for our injured employees, and they will partner with our adjusters to develop a personalized  holistic approach  for each claim.  These responsibilities may include  utilization  review, pharmacy oversight...

Company Details   WR. Berkley Corporation, founded in 1967, is one of the nation’s premier commercial lines property casualty insurance providers. Founded in 2004, Berkley Environmental has underwriting and account executive units in seven regions. Berkley Environmental offers an array of coverages for virtually all classes traditionally known to have environmental liability exposures on both an admitted and non-admitted basis. We provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers’ compensation, along with claim services, providing expertise to meet the unique business needs of our customers.   www.berkleyenvironmental.com Responsibilities The auto liability claims department is looking for an experienced Auto Liability Claims Examiner individual contributor to handle moderate complexity auto claims in a fast paced energetic environment within our organization....

Company Argo Group Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Business Title(s):   Chief Claims Officer, Argo Group   Employment Type:   Full-Time   FLSA Status : Exempt   Location : In-Office     Summary:   The   Chief   Claim s   Officer , Argo Group   reports directly to the Chief   Claims   Officer ,   Clearbrook   located in New York City and   manages the entire Claims   function for Argo .   As a member of the executive   management   team, the Chief Claims Officer , Argo   Group   is responsible for   the overall strategic direction, executive   leadership,   and management of all the...

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Job Description Position Summary The Claims Division is seeking a team member to join the National Accounts Casualty (NAC) Team as a Claims Account Manager (CAM). In this role, the responsibilities include but not limited to actively manage and effectively oversee assigned NAC business accounts for Worker's Compensation claims written on a guaranteed cost basis, high deductible, and self-insured retention basis handled by third party administrators.  Responsibilities Work with our TPA’s to ensure proper claims handling and service delivery, which includes: Performing claims oversight on claims with an expected value over $50,000 for guaranteed cost...

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote position but does require travel. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim...

The Workers’ Compensation Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The WC Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises WC claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional...

Company Details     With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that provide our clients the freedom to do what they do best. Offering guaranteed cost options to employers nationwide, Key Risk focuses on delivering products and services within specialized verticals to reduce workers' compensation exposures and deliver industry-leading results.   All products and services are distributed through appointed insurance agents and brokers. Key Risk is a member company of W. R. Berkley Corporation, whose insurance company subsidiaries are rated A+ (Superior), Financial Size Category XV by A.M. Best Company and A+ (Strong), by S&P.   For further information about Key Risk please visit  www.KeyRisk.com   Responsibilities The  Workers’ Compensation Claims Representative III is responsible for the analysis and management of complex...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Adjuster | NY Jurisdictional Knowledge & NY Licensing Required | Dedicated Public Entity Client & Capped Caseloads Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?    Apply your  New York Workers Compensation Adjuster  knowledge and experience to adjudicate complex customer claims in the context of an energetic culture....

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Description The Assistant Vice President, Central Operations is responsible for managing a portfolio of Operations Centers located in US branch offices and the Philippines. This position utilizes their expertise to drive LEAN principles and methodology to assess current state and continuously improve processes and procedures in close collaboration with various internal stakeholders. The AVP works independently under guidance from the VP to provide subject matter expertise in establishing and maintaining an Operational Center of Excellence. Primary Responsibilities may include but not limited to: Direct oversight of Central work team(s) based onshore and offshore across the...

Argo Group International Holdings, Inc .  and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. (“BWS”), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions. Job Description Business Title(s):   Workers’ Compensation Claims Adjuster   Employment Type:   Regular   FLSA Status:   Exempt   or Non-Exempt   Location:   In-Office     Summary:    We are looking for a highly capable Workers’ Compensation Claims Adjuster to join our Claims team and work from either our Rockwood, PA or Omaha, NE offices. Alternatively, we can also fill this role in our offices in Richmond, VA or Springfield, MO....

Overview Good Things Start Here. Good things are happening at Berkshire Hathaway GUARD Insurance Companies—an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway. With supportive leadership, collaborative teams, and opportunities to grow, GUARD is a place where people build meaningful, long‑term careers.   Good Things You Can Count On. Hybrid schedule: 2 days remote / 3 in‑office Predictable hours (no nights, weekends, or holidays) Competitive pay + generous PTO Medical, dental & vision starting day one 401(k), tuition reimbursement & longevity bonuses Responsibilities The Medical Claims Representative manages Workers' Compensation medical-only claims while providing timely service to injured workers, employers, and medical providers. This role is responsible for the  communication, coordination and administration of Workers’ Compensation claims....

Overview Good Things Start Here. Good things are happening at Berkshire Hathaway GUARD Insurance Companies—an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway. With supportive leadership, collaborative teams, and opportunities to grow, GUARD is a place where people build meaningful, long‑term careers. Good Things You Can Count On. Hybrid schedule: 2 days remote / 3 in‑office Predictable hours (no nights, weekends, or holidays) Competitive pay + generous PTO Medical, dental & vision starting day one 401(k), tuition reimbursement & longevity bonuses Responsibilities GUARD is seeking an actuarial professional to join our growing Actuarial team. This position is open at either the  Actuarial Assistant or Actuarial Analyst level and will be filled based on the selected candidate's experience, actuarial exam progress, technical skills, and overall...

Company Story: Seek Now is a customer experience-technology company leveraging a network of professional experts to provide data-driven inspections. We deliver ground truth to property & casualty, real estate, and finance customers that enable them to solve their business problems in a matter of hours…minutes…seconds. Seek Now is well-positioned to disrupt the inspection world through a combination of our hard-working 3rd party contractors, talented employees, vast network, and cutting-edge technology.  For us, it is all about solving business problems for our customers.  Our proven methods, commitment to excellence, and diverse team of professionals are what set Seek Now apart.  The claim volume and opportunity has never been greater than it is now.  So, if you have been thinking about making a change, this may be a great fit for you and your business! Position Summary: Seek Now is searching for reliable, skilled, and experienced 1099 independent contractors...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.    This position is remote in Pennsylvania ! Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively, concurrently or...