[Hiring] Workers' Compensation Lost Time Adjuster @Davies

Role Description

We are seeking a Workers’ Compensation Lost Time Claims Adjuster to investigate, evaluate, and manage Workers’ Compensation claims while delivering timely, cost-effective resolutions and exceptional client service. This role manages claims of increasing complexity based on level, including moderate to complex losses, litigated matters, and catastrophic exposures. The adjuster develops and executes strategic action plans to ensure claims are resolved appropriately, efficiently, and in compliance with jurisdictional requirements.

• Own the full lifecycle of Workers’ Compensation claims, from initial investigation through resolution
• Determine compensability and coverage with confidence and accuracy
• Conduct detailed investigations, including interviews and evidence gathering
• Analyze medical, legal, and employment documentation to guide decision-making
• Manage EDI reporting and ensure CMS Section 111 compliance
• Develop and execute strategic claim plans for complex and litigated files
• Partner with defense counsel to drive effective litigation strategies and control costs
• Negotiate settlements with claimants and attorneys to achieve optimal outcomes
• Handle catastrophic and high-severity claims with care and precision
• Leverage preferred vendors and cost-containment tools effectively
• Deliver clear, insightful reporting to clients and excess carriers
• Maintain strong client relationships through responsive, professional communication
• Stay current on jurisdictional requirements, trends, and best practices
• Support team development through mentorship and knowledge sharing

Qualifications

• 3+ years of Workers’ Compensation claims handling experience
• Experience with lost time claims, compensability analysis, and claim strategy preferred
• Active adjuster licenses as required by jurisdiction (or ability to obtain)
• Direct experience handling Workers’ Compensation claims (level‑dependent)
• Knowledge of Workers’ Compensation laws and jurisdictional requirements
• Understanding of medical terminology and its impact on claim exposure
• Strong investigation, analysis, and decision‑making skills
• Effective negotiation and communication abilities
• Ability to manage multiple priorities in a fast‑paced environment
• Proficiency with claims systems and related technology
• Professionalism in handling sensitive or confidential information

Benefits

• 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