Workers Compensation Claims Adjuster - Remote

Job Description

A well-established Third-Party Administrator (TPA) is seeking an experienced Senior Workers’ Compensation Claims Adjuster to join their team supporting New York
. This role is fully remote and requires a seasoned claims professional who can independently manage a complex Vermont workers’ compensation caseload while delivering excellent service to both the client and injured workers.

The ideal candidate will have strong knowledge of Vermont workers’ compensation statutes
, proven experience handling litigated and complex claims, and the ability to manage claims from inception through resolution.

• $80,000 - $95,000/year
• Annual Bonus Potential
• 100% Remote Work Environment
• Comprehensive benefits package
• Opportunity to support a stable, long-term dedicated account
• Collaborative and supportive claims leadership team

• 5+ years of Workers’ Compensation Claims Adjusting experience, within the New York jurisdictions is required
• Strong understanding of NY Workers’ Compensation regulations and claims procedures.
• Experience handling complex and litigated claims.
• Prior experience working for a TPA or insurance carrier preferred.
• Strong organizational, analytical, and negotiation skills.
• Ability to manage a full caseload independently in a remote work environment.
• Active Connecticut adjuster license or ability to obtain quickly.

• Manage a full caseload of New York workers’ compensation claims from inception to closure.
• Investigate claims thoroughly to determine compensability and appropriate reserves.
• Ensure all claims are handled in compliance with New England workers’ compensation laws and regulatory requirements.
• Coordinate and communicate with injured workers, employers, medical providers, attorneys, and other stakeholders.
• Establish and adjust reserves based on claim developments and exposure.
• Direct medical management, including coordination with nurse case managers when appropriate.
• Evaluate claims for settlement opportunities and participate in negotiations when necessary.
• Manage litigated claims, working closely with defense counsel to develop strategies and control costs.