Sr. Claims Examiner

Acrisure•Chandler, AZ

1d•Onsite

About The Position

The Senior Workers Compensation Claims Adjuster manages workers’ compensation claims from investigation through resolution, with a focus on medical-only claims and some indemnity exposure. The role evaluates compensability and liability, monitors medical treatment and return-to-work activity, and works with clients, employers, injured workers, physicians, attorneys, and defense counsel to move claims toward timely resolution. The position requires an on-site presence to support collaboration, team leadership, and cross-functional partnership.

Requirements

At least 3 years of workers’ compensation claims handling experience, or an equivalent combination of training, education, and experience.
Arizona adjuster license.
Experience evaluating workers’ compensation claims, including compensability, exposure, reserves, medical treatment, and claim resolution.
Analytical and critical-thinking skills to evaluate claim information, documentation, and applicable workers’ compensation requirements.
Attention to detail when reviewing claim documentation, policies, medical information, and required filings.
Clear written and verbal communication skills and ability to work effectively with clients, employers, claimants, medical providers, attorneys, and other involved parties.
Negotiation, organization, and time-management skills to manage an active workers’ compensation caseload.
Ability to calculate figures associated with claim handling and reserves.
Comfort with an on-site presence.

Nice To Haves

At least 5 years of workers’ compensation claims handling experience.
Multi-state adjuster licenses.
Experience working with defense counsel and the workers’ compensation litigation process.
Experience completing state filings with industrial commissions.
Experience with FileHandler.
Bilingual skills.

Responsibilities

Investigate workers’ compensation claims by gathering information from claimants, witnesses, employers, medical providers, police and hospital records, and other relevant sources.
Determine compensability and liability under applicable workers’ compensation statutes and recommend claim coverage and direction.
Monitor medical treatment and progress, coordinate follow-up care and pre-certification when needed, and communicate work restrictions and return-to-work information to employers.
Manage claim reserves and issue medical, indemnity, legal, and expense payments based on claim exposure and supporting information.
Maintain current and accurate claim documentation, manage diary follow-ups, and review claim submissions for completeness and accuracy.
Provide clients with guidance on claim direction based on information gathered and analyzed throughout the claim lifecycle.
Coordinate with attorneys and defense counsel on litigated claims while maintaining responsibility for overall claim direction.
Complete required jurisdictional and state filings, prepare reports for excess carriers, and request reimbursement when applicable.