Workers' Compensation Adjuster (Louisiana - Remote)

Davies • Home, AL

3d • Remote

About The Position

Davies North America is seeking a Louisiana Workers’ Compensation Claims Adjuster to investigate, evaluate, and manage Workers’ Compensation claims while delivering timely, cost-effective resolutions and exceptional client service. The position manages claims of increasing complexity according to level, including moderate to complex losses, litigated matters, and catastrophic exposures. The adjuster develops and executes strategic action plans to resolve claims appropriately, efficiently, and in compliance with jurisdictional requirements.

The role independently handles claims of moderate complexity, including medical-only and lost-time files. It involves investigating claims, determining compensability, evaluating exposure, setting appropriate reserves, managing medical and legal developments, and planning resolution with increasing independence. The adjuster handles some litigated matters and applies sound judgment in negotiations, reserving, and file direction. The role is remote and focused on Louisiana Workers’ Compensation claims.

Requirements

• At least 3 years of Workers’ Compensation claims handling experience.
• Active adjuster licenses as required by Louisiana, or ability to obtain them.
• Knowledge of Louisiana Workers’ Compensation laws and jurisdictional requirements.
• Understanding of medical terminology and its impact on claim exposure.
• Strong investigation, analysis, and decision-making skills.
• Effective negotiation and communication abilities.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency with claims systems and related technology.
• Professionalism in handling sensitive or confidential information.

Nice To Haves

• Experience with lost-time claims, compensability analysis, and claim strategy.
• Direct experience handling Louisiana Workers’ Compensation claims, depending on level.

Responsibilities

• Manage the full lifecycle of Workers’ Compensation claims, from initial investigation through resolution.
• Determine compensability and coverage accurately.
• Conduct detailed investigations, including interviews and evidence gathering.
• Analyze medical, legal, and employment documentation to guide claim decisions.
• Manage EDI reporting and ensure CMS Section 111 compliance.
• Develop and execute strategic claim plans for complex and litigated files.
• Partner with defense counsel on litigation strategies and cost control.
• Negotiate settlements with claimants and attorneys.
• Handle catastrophic and high-severity claims.
• Use preferred vendors and cost-containment tools effectively.
• Provide clear reporting to clients and excess carriers.
• Maintain strong client relationships through responsive, professional communication.
• Stay current on jurisdictional requirements, trends, and best practices.
• Support team development through mentorship and knowledge sharing.
• Investigate claims, determine compensability, evaluate exposure, and establish appropriate reserves.
• Manage claim strategy, medical and legal developments, and resolution planning.
• Maintain compliance with jurisdictional requirements and client service expectations.
• Maintain regular and dependable attendance and be available to perform responsibilities during established work hours.

Benefits

• Medical, dental, and vision plans.
• 401(k) plan with employer matching.
• Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees.
• Paid holidays.
• Life insurance.
• Short-term and long-term disability coverage.
• Paid sick leave, paid family leave, and paid parental leave where required by law.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed