Workers’ Compensation Medical Only Claims Adjuster (Remote)

Davies • Home, WV

4d • $48,000 - $55,000 • Remote

About The Position

Davies North America is seeking a Workers’ Compensation Medical Only Claims Adjuster to manage Workers’ Compensation claims from intake through resolution. Depending on the assigned client program, the role may support medical-only claim types. The adjuster investigates, evaluates, and manages claims in accordance with company guidelines, client expectations, and jurisdictional requirements.

Requirements

• 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.
• Active Florida license required.

Nice To Haves

• 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 state regulations and internal standards.
• Maintain regular and dependable attendance and be available to perform job 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.
• Where required by law, paid sick leave, paid family and parental leave, and other mandated benefits.

What This Job Offers

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