Workers' Medical Adjuster; Remote

Department: Claims Administration & Adjusting

Employment Type: Permanent - Full Time

Location: Home United States

Reporting To: Supervisor WC TPA

Compensation: $45,500 - $50,050 / year

Imagine being part of a team that isn't 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.

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. You must be licensed in FL to handle workers' compensation claims.

This role manages Workers' Compensation claims from intake through resolution and support medical-onlyclaim types. The adjuster investigates, evaluates, and manages claims in accordance with company guidelines, client expectations, and jurisdictional requirements.

• 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
• Client Communication & Compliance
• Provide timely updates to clients and stakeholders
• Ensure compliance with all state regulations and internal standards

• 3+ years of Workers' Compensation claims handling experience
• Must have an active and valid license in FL (5-20 or 6-20)
• Experience with medical-only Workers' Compensation claim portfolios preferred
• Independently handles Workers' Compensation claims of moderate complexity
• Determines compensability, conducts investigations, evaluates exposure, and establishes appropriate reserves
• Manages claim strategy, treatment progression, indemnity administration, and return-to-work coordination
• Handles some litigated matters and applies sound judgment in negotiations, reserving, and file direction
• Maintains compliance with jurisdictional requirements, client service expectations, and internal standards

At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and vision plans to support your health and that of your family
• A 401(k) plan with employer matching
• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees
• Paid holidays
• Life insurance and short-term and long-term disability coverage

Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee's primary work location.

Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.

Davies is dedicated to fostering a diverse and inclusive…