Workers' Claims Adjuster

Overview

As a Workers’ Compensation Claims Adjuster, you will own the full lifecycle of assigned claims—from first report through resolution. This is a high-visibility, client-facing role where you are trusted to make sound decisions, manage costs responsibly, and move claims forward with urgency and discipline. Success in this role means delivering timely, compliant, and well-documented claim outcomes while maintaining strong employer confidence and meeting defined closure and performance targets.

• Manage a full caseload of workers’ compensation indemnity claims, driving each claim toward timely and cost-effective resolution.
• Conduct thorough investigations, determine compensability, establish and maintain accurate reserves, and document clear, forward-looking claim strategies.
• Actively manage medical treatment plans using evidence-based guidelines (including Official Disability Guidelines), initiate Independent Medical Examinations when appropriate, and coordinate return-to-work and vocational strategies to reduce indemnity duration.
• Ensure strict compliance with Hawaii workers’ compensation statutes, regulatory deadlines, benefit payments, and hearing preparation before the Hawaii Department of Labor and Industrial Relations, Disability Compensation Division.
• Communicate proactively with employers, injured workers, attorneys, and medical providers—setting expectations early, explaining decisions clearly, and managing escalations with professionalism and authority.

You are a decisive, analytical claims professional who takes full ownership of outcomes. You are comfortable making difficult calls, defending your rationale, and operating in an environment where performance standards are high and visibility is real. You bring strong judgment, disciplined file management, and the ability to balance cost control with regulatory compliance and client trust.

• Demonstrated success managing full-cycle workers’ compensation claims, including indemnity exposure and litigated files.
• Strong working knowledge of Hawaii workers’ compensation statutes, compliance requirements, and hearing procedures.
• Proven ability to analyze medical documentation and apply evidence-based treatment guidelines to manage claim direction.
• Experience establishing and defending compensability decisions, reserve strategy, and settlement recommendations.
• Clear, structured written documentation skills with the ability to articulate claim rationale and strategy in audit-ready files.
• Ability to manage a high-volume caseload (approximately 90–100 active claims) while maintaining accuracy, urgency, and professionalism.

At Pro Service Hawaii, we empower businesses and employees across the islands by delivering HR solutions that work. As Hawaii’s largest local HR partner, we support thousands of organizations with payroll, benefits, risk management, and more. With over 18 consecutive years as a Best Place to Work, we’re committed to fostering a purpose-driven, inclusive, and high-performing culture where people take ownership and do what’s right—for clients and for each other.

We Believe Great Work Happens When People Are Trusted, Supported, And Challenged To Grow. We’re Building a Workplace Where High Standards And a Strong Sense Of Purpose Go Hand-in-hand—and Where Your Contributions Directly Impact Hawaii’s Employers, Their Employees, And The Broader Communities We Serve. Here’s What You Can Expect

• A Culture That Means Something:
  Our Core Values aren’t just words on a wall. They guide how we work, make decisions, and support one another.
• Trust and Autonomy:
  You’ll be empowered to manage your responsibilities with clarity and independence, backed by a team that shares your commitment to doing things right.
• Real Opportunities to Grow:
  Whether you're looking to deepen your expertise or step into leadership, you'll have access to feedback and coaching, development programs, mentorship, and clear paths forward.
• Flexibility with Accountability:
  For Hawaii-based employees, we offer hybrid work options. For those on the mainland, we offer fully remote roles, so long as you are ready to work on Hawaii Standard Time.
• Competitive Compensation and Benefits:
  We value your contributions and back that up with strong pay $71,000.00 to $98,000.00 per year, full benefits, and resources to support your well-being.