20 workers compensation complex claims adjuster jobs found

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 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...

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...

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...

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 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...

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description Join our team as a Field Auto Adjuster and make a real impact on the auto claims process! In this role, you’ll be on the front lines, writing estimates directly at customer homes, repair shops, or tow yards, and ensuring a smooth and efficient claims experience. You’ll engage in a variety of interactions – whether face-to-face, virtual, or written – as you assess damages and finalize estimates with both customers and repair shops. With a dynamic range of tasks including repairable estimates, total loss assessments, and virtual...

If you’re passionate about helping people protect what matters most to them at a Fortune 100 company with nearly $70 billion in annual sales, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers and partners are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. This is a work-from-home position with day travel   to policy locations in Western PA   via company vehicle (personal use, gas and maintenance included). Claims inspections will include onsite and virtual inspection. Travel is estimated to be 50% for this role. Candidate Location: Pittsburgh, PA (preferred) Qualifications: ·         3-5 years of insurance field/property claims handling or adjusting experience ·         Solid experience with XactContents ·...

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...

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source Provide assessment, planning, implementation, and evaluation of...

As one of the leading writers of Federal Crop Insurance, AgriSompo North America combines industry experience, resources, capital and talent to deliver both traditional and innovative crop insurance and productivity tools to farmers, ranchers, insurers and agribusinesses in the United States. Our organization operates within a culture rooted in ethics, integrity and a belief that accountability, collaboration and agility are crucial to long-term success.  AgriSompo North America is a part of AgriSompo, Sompo International’s global agriculture platform. This platform is an integrated underwriting, technology and distribution platform delivering innovate insurance and reinsurance solutions to agriculture partners worldwide.  Sompo International, AgriSompo’s parent company, is a global organization driven by its core values, a carrier that holds promise, trust and the commitment to protect.  Through operating subsidiaries, Sompo International writes agriculture, casualty and...

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description As a Field Auto Adjuster, you will play a crucial role in our Auto claims handling process by writing estimates directly at customer homes, repair shops, or tow yards. Your job will involve a variety of customer/shop interactions, including face-to-face, virtual, and written communication, as you assess and finalize estimates. With a diverse range of workstreams, including repairable estimates, total loss assessments, and virtual inspections, you will enjoy a dynamic and engaging work environment. You must live in/near the Philadelphia...

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...

About the Role   American Global has an exciting and growing opportunity to join our team as a Senior Workers' Comp Claims Advocate. This is a highly visible role working with clients, insurance carriers, and our internal team. We are looking to add a passionate, talented individual who will help our growing claims department deliver exceptional customer service to our clients.    Key   Respon sibilities   Include:   Support claims team with day-to-day monitoring of claims activities of carriers and third-party administrators   Facilitate claim reviews with clients and/or insurance carriers when needed   Partner with client legal counsel on coverage, claims and strategy for settlement   Facilitate periodic claim reviews with clients and/or insurance carrier focusing on reserving practices,   strategy   and resolution   Analyze claim information for frequency and severity trends and   assist...

The Customer Service Representative plays a vital role in supporting the Workers’ Compensation department by managing inbound and outbound calls and providing exceptional service to claimants and internal teams. This entry-level position is ideal for individuals looking to start a career in insurance, claims management, or customer service within a professional environment. You will assist claim adjusters by addressing inquiries, clarifying information, and ensuring accurate communication between all parties. Training will be provided to help you succeed and grow in this role. This role requires internet upload and download speeds of at least 80Mbps. This role is available for both remote and hybrid work arrangements.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Answer and return inbound and outbound phone calls promptly and professionally. Review claim history in the system and provide accurate information to callers. Collaborate with claim adjusters to...

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...

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...

Overview Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett’s Berkshire Hathaway group – one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.   Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company’s success is grounded in our core values:  accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!...