Workers' Compensation Medical Only Adjuster (Remote)
About The Position
Our Story Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. What's in Store At Davies North America, we’re focused on delivering smart, efficient claims solutions that make a real impact for our clients. We’re seeking a Workers’ Compensation Medical Only Claims Adjuster who brings strong technical expertise, sound judgment, and a proactive approach to managing indemnity and medical-only claims. This role manages Workers’ Compensation claims from intake through resolution and may support medical-only claim types depending on the assigned client program. The adjuster investigates, evaluates, and manages claims in accordance with company guidelines, client expectations, and jurisdictional requirements.
Requirements
- 3+ years of Workers’ Compensation claims handling experience
- Active FL license
- Strong knowledge of Workers’ Compensation laws, benefit structures, and claims processes
- Experience managing indemnity payments and return-to-work programs
- Ability to handle multiple claims in a fast-paced environment
- Strong investigative, analytical, and decision-making skills
- Effective negotiation and problem-solving abilities
- Excellent written and verbal communication skills
- Proficiency with claims management systems and related technology
- Active adjuster license(s) or ability to obtain as required
Nice To Haves
- Experience with medical-only, lost time, or blended Workers’ Compensation claim portfolios preferred
- Multi-state claims handling experience
- Experience with EDI reporting and jurisdictional compliance requirements
- Familiarity with nurse case management and medical cost containment strategies
Responsibilities
- Manage Workers’ Compensation claims from intake through closure
- Determine compensability and benefit eligibility
- Establish and adjust reserves based on claim exposure
- Conduct investigations, including interviews and documentation review
- Develop and execute claim strategies
- Identify opportunities for early resolution
- Monitor treatment plans and coordinate return-to-work efforts
- Administer indemnity benefits in compliance with jurisdictional requirements
- Coordinate with defense counsel on litigated claims
- Support hearings, mediations, and settlements
- Provide timely updates to clients and stakeholders
- Ensure compliance with all state regulations and internal standards
Benefits
- Medical, dental, and vision plans to support your health and that of your family
- A 401(k) plan with employer matching
- Discretionary Time Off (DTO) for exempt employees
- Paid Time Off (PTO) for non-exempt employees
- Paid holidays
- Life insurance and short-term and long-term disability coverage
- Paid sick leave
- Paid family and parental leave
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
