Senior Workers’ Compensation Adjuster for IL/IN/KY/MI
Fully remote
Mid salary range: $75k-85k
We are seeking a Senior Workers’ Compensation Claims Specialist to manage complex, high-profile claims while maintaining strong customer service standards and driving cost-effective claim outcomes. Working closely with case managers, outcome managers, and legal counsel, you will oversee claim investigations, subrogation, settlement negotiations, and return-to-work efforts.
Essential Functions & Responsibilities
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Receive Workers’ Compensation claims, confirm policy coverage, and issue formal acknowledgments.
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Investigate claim validity and compensability, filing required documentation with state regulatory agencies.
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Establish reserves and authorize payments within assigned reserving authority limits.
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Develop and execute documented action plans alongside case managers to optimize outcomes and minimize overall claim costs.
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Coordinate early return-to-work programs and manage claim litigation, subrogation, and recoveries.
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Report applicable claims to excess carriers and communicate status updates to claimants, clients, and policyholders.
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Ensure strict compliance with state-specific Workers’ Compensation rules, regulations, and carrier guidelines.
Qualifications & Requirements
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State Jurisdiction Knowledge: Knowledge of Workers’ Compensation laws in at least two (2) of the following states is strictly required: IL, IN, KY, or MI. Strong experience in Indiana (IN) is highly desired for immediate desk assignments.
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Licensure: Must possess an active Designated Home State (DHS) license or state equivalent adjuster license. State certification/licensure must be maintained throughout employment.
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Experience: Minimum of 3 years of hands-on Workers’ Compensation claims handling experience.
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Education: Bachelor’s degree or an equivalent combination of education and direct industry experience. Self-Insured Certificate is preferred.
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Technical & Soft Skills: Proficiency in Microsoft Office (Excel, Word, Outlook), strong analytical problem-solving abilities, excellent written and verbal communication, and the ability to mentor junior team members on claims practices