Workers' Compensation Claim Adjuster, Sr. - Hybrid

Ccmsi • West Des Moines, IA

6d • Hybrid

About The Position

We are seeking an experienced and highly skilled Workers’ Compensation Claim Consultant who is responsible for managing a full caseload of indemnity workers’ compensation claims across multiple accounts and industries, including healthcare, manufacturing, warehouse, agriculture, hospitality, restaurant, and transportation environments. This role handles primarily moderate-complexity claims with some litigation exposure across Iowa and Nebraska jurisdictions, providing high-quality claim outcomes through sound judgment, effective communication, and adherence to corporate and client standards. This is a full life‑cycle WC adjuster position within a TPA environment, and only candidates with proven Workers’ Compensation claims experience will be considered.

Requirements

• Active Iowa workers’ compensation adjuster license
• Minimum of 5 years of workers’ compensation indemnity claim handling experience
• Experience handling claims with some litigation exposure
• Ability to determine claim settlement values and negotiate claims for resolution
• Strong written and verbal communication skills with the ability to build rapport with clients and claimants
• Critical thinking and sound decision-making skills
• Proficiency with Microsoft Outlook and Word
• Strong organizational skills with the ability to manage competing priorities

Nice To Haves

• Experience handling both national and non-national accounts
• Experience across multiple industries including healthcare, manufacturing, warehouse, agriculture, hospitality, restaurant, or transportation
• Prior TPA experience helpful, but not required
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required

Responsibilities

• Investigate, evaluate, and adjust workers’ compensation claims in accordance with established claim handling standards, client-specific instructions, and state laws
• Manage a caseload of approximately 125 claims across multiple accounts
• Establish reserves and provide reserve recommendations within established authority levels
• Review, approve, and oversee medical, legal, and miscellaneous invoices for accuracy and claim-related necessity
• Negotiate disputed bills and invoices for appropriate resolution
• Authorize and issue claim payments utilizing established claim payment programs and authority guidelines
• Negotiate settlements in accordance with corporate standards, client instructions, and jurisdictional requirements
• Assist in the selection, referral, and oversight of outside vendors including legal counsel, surveillance, and case management
• Monitor and pursue subrogation opportunities through resolution
• Maintain accurate claim documentation, diary management, reserves, and payments within the claim system
• Prepare reports detailing claim status, reserves, and payments as requested
• Compute disability rates in accordance with state laws
• Coordinate effective and timely communication with clients, claimants, attorneys, and other involved parties
• Attend and participate in hearings, mediations, and informal legal conferences as appropriate
• Conduct client claim reviews or training sessions when requested
• Ensure compliance with corporate claim handling standards and special client handling instructions

Benefits

• 4 weeks (Paid time off that accrues throughout the year in accordance with company policy)
• 10 paid holidays in your first year
• Medical, Dental, Vision, Life, and Disability Insurance
• 401(k) and Employee Stock Ownership Plan (ESOP)

What This Job Offers

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