Workers Compensation Claims Adjuster

Workers Compensation Claims Adjuster I

Summary
:
Under close supervision, the Claims Adjuster analyzes insurance claims to determine the extent of the insurance carrier's liability and settles claims with claimants in accordance with policy provisions.

• Identify and address questionable (AOE/COE) claims.
• Establish and monitor reserves at periodic intervals.
• Prepare claims status reports to carriers at 90‑day intervals.
• Manage and direct medical care, including strategies to maintain medical control and objection when appropriate.
• Identify and rate permanent disability.
• Manage vocational rehabilitation file.
• Negotiate and finalize claim settlements and lien settlements.
• Identify and manage subrogation issues on workers’ compensation claims.
• Work independently in a fast‑paced environment.

• Perform three‑point contact, initial investigation, and initial benefit determination.
• Execute all responsibilities listed above.

• Problem Solving – Identifies and resolves problems promptly; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem‑solving situations; uses reason even when dealing with emotional topics.
• Customer Service – Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments.
• Interpersonal – Focuses on solving conflict, not blaming; maintains confidentiality; listens to others without interrupting; keeps emotions under control; remains open to others’ ideas and tries new things.
• Team Work – Supports everyone's efforts to succeed.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• At least 1‑3 years of experience as a Workers’ Compensation Claims Assistant, or up to one year of Trainee or Future Med Adjuster experience.
• Or Bachelor’s degree (B.A.) and six months of experience.

We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.

$24.00 – $34.00 per hour.