Senior New England Workers Compensation Claims Adjuster
About The Position
A well-established Third-Party Administrator (TPA), is seeking an experienced Senior Workers’ Compensation Claims Adjuster to join their team supporting a New England accounts . This role is fully remote and requires a seasoned claims professional who can independently manage a complex Vermont workers’ compensation caseload while delivering excellent service to both the client and injured workers. The ideal candidate will have strong knowledge of New England workers’ compensation statutes , proven experience handling litigated and complex claims, and the ability to manage claims from inception through resolution.
Requirements
- 5+ years of Workers’ Compensation Claims Adjusting experience , with either MA, CT, NH, VT, ME, or RI claim handling required.
- Strong understanding of New England Workers’ Compensation regulations and claims procedures .
- Experience handling complex and litigated claims .
- Prior experience working for a TPA or insurance carrier preferred.
- Strong organizational, analytical, and negotiation skills.
- Ability to manage a full caseload independently in a remote work environment .
- Active adjuster license or ability to obtain quickly.
Nice To Haves
- Prior experience working for a TPA or insurance carrier preferred.
Responsibilities
- Manage a full caseload of New England workers’ compensation claims from inception to closure.
- Investigate claims thoroughly to determine compensability and appropriate reserves.
- Ensure all claims are handled in compliance with New England workers’ compensation laws and regulatory requirements .
- Coordinate and communicate with injured workers, employers, medical providers, attorneys, and other stakeholders.
- Establish and adjust reserves based on claim developments and exposure.
- Direct medical management, including coordination with nurse case managers when appropriate.
- Evaluate claims for settlement opportunities and participate in negotiations when necessary.
- Manage litigated claims , working closely with defense counsel to develop strategies and control costs.
- Maintain accurate claim documentation and provide timely claim updates to the client.
- Deliver high levels of customer service to a dedicated client account while meeting all service standards and KPIs.
Benefits
- Comprehensive benefits package
- Opportunity to support a stable, long-term dedicated account
- Collaborative and supportive claims leadership team
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
