This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

A well-established Third-Party Administrator (TPA) is seeking an experienced Senior Workers’ Compensation Claims Adjuster to join their team supporting New England accounts. 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.

• Manage a full caseload of New England 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.
• Maintain accurate claim documentation and provide timely claim updates to the client.
• Deliver high levels of customer service to a dedicated client account while meeting all service standards and KPIs.

Qualifications

• 5+ years of Workers’ Compensation Claims Adjusting experience, with either MA, CT, NH, VT, ME, or RI claim handling required.
• Strong understanding of New England 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 adjuster license or ability to obtain quickly.

Requirements

• Strong knowledge of New England workers’ compensation statutes.
• Proven experience handling litigated and complex claims.

Benefits

• Compensation: $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