• $80K - $90K Annually (based on experience)
• Annual bonus potential
• Flex schedule and ability to work remotely
• 401k Plan
• Health and Dental Plan
• Generous PTO 

 #LI-PR1 

California Workers Compensation Adjuster (Permanent)

Job Summary

Seeking a highly skilled and experienced Workers Compensation Claims Adjuster to join a team. This role involves managing all aspects of workers compensation claims, including determining compensability, verifying coverage, administering disability and medical benefits, negotiating claim resolutions, and providing exceptional service to injured employees, employers, and medical/legal professionals.

Compensation Package

• Medical, dental, and vision insurance
• Life insurance
• 401(K) with company match
• Opportunities for professional growth and development in a supportive and collaborative environment

Responsibilities

• Receive and manage newly reported claims
• Maintain and update claim notes throughout the lifespan of claims
• Record claim information in an electronic database
• Conduct interviews with claimants, insureds, medical professionals, and witnesses to determine claim validity
• Communicate claim compensability decisions to claimants, employers, and medical providers
• Set appropriate reserves based on the nature and extent of injuries
• Calculate lost time wages and administer disability payments
• Coordinate independent medical examinations and prepare relevant documentation
• Maintain regular correspondence with claimants, insureds, and nurse case managers
• Review and process medical bills through third-party vendors for additional discounts
• Collaborate with claimants and insureds to facilitate early return-to-work
• Partner with legal counsel to protect insured interests on litigated claims
• Attend settlement conferences, mediations, and hearings on behalf of the company or insured
• Review and approve defense attorney bills within authority
• Provide relevant loss information to underwriting and risk management teams
• Respond to state requests for health cost disputes, applications for hearings, and penalty assessment letters
• Identify subrogation opportunities and pursue recovery
• Lead claim reviews with clients as requested
• Perform other duties as assigned

Qualifications/Requirements

• Minimum of 10 years of experience adjusting Workers Compensation Claims in California
• SIP Certification is required
• Bilingual proficiency in Spanish and English is required
• Current with Continuing Education Units (CEUs)
• Proficiency in the Microsoft Office suite
• In-depth knowledge of California workers compensation laws
• Strong understanding of medical terminology and treatment progression
• Excellent oral and written communication skills
• Exceptional attention to detail and organizational abilities
• Proven negotiation skills for resolving issues and settlements
• Strong customer service orientation with a commitment to timely responses
• Adaptability to changing technologies and new systems
• Ability to establish and maintain effective working relationships with others

#LI-BR1

Workers' Compensation Claims Adjuster

Job Summary

Seeking a seasoned Workers' Compensation Claims Adjuster to join a Third-Party Administration team. The role involves managing all aspects of workers' compensation claims, including determining compensability, verifying coverage, administering benefits, negotiating claim resolutions, and providing support to injured employees, employers, and medical/legal professionals throughout the claim lifecycle.

Compensation Package

• Medical, dental, and vision insurance
• Life insurance
• 401(k) plan with company match

Responsibilities

• Receive and manage newly reported claims.
• Maintain and update claim notes throughout the claim lifecycle.
• Record claim information in the electronic database.
• Conduct interviews with claimants, insureds, medical professionals, and witnesses to determine claim validity.
• Communicate claim compensability decisions to claimants, employers, and medical providers.
• Set appropriate reserves based on the nature and extent of injuries.
• Calculate lost time wages, administer disability payments, and manage payment schedules.
• Coordinate independent medical examinations and prepare relevant documentation for review.
• Maintain regular correspondence with claimants, insureds, and nurse case managers.
• Review and process medical bills through third-party vendors for additional discount opportunities.
• Collaborate with claimants and insureds to facilitate early return-to-work initiatives.
• Partner with legal counsel to protect insureds' interests on litigated claims, including providing necessary documentation and evaluating claim exposure.
• Attend settlement conferences, mediations, and hearings on behalf of the insurance company/insured.
• Review and approve defense attorney bills within authority limits.
• Work with underwriting and risk management teams to provide relevant loss information and identify trends.
• Respond to state requests for health cost disputes, applications for hearings, and penalty assessment letters.
• Identify subrogation opportunities and pursue recovery.
• Lead claim reviews with clients as requested.
• Perform other duties as assigned.

Qualifications/Requirements

• Minimum of 10 years of experience adjusting Workers' Compensation Claims in California.
• SIP Certification is required.
• Bilingual proficiency in Spanish and English is required.
• Current with Continuing Education Units (CEUs).
• Proficiency in the Microsoft Office suite.
• Strong knowledge of relevant workers' compensation laws.
• Solid understanding of medical terminology and familiarity with medical case progression.
• Excellent oral and written communication skills.
• Exceptional attention to detail and organizational abilities.
• Strong negotiation skills for resolving issues and settlements.
• Commitment to providing outstanding customer service, including timely responses to inquiries.
• Adaptability to changing technologies and the ability to learn new systems.
• Proven ability to establish and maintain effective working relationships with others.

#LI-BR1

Complex Claims Specialist (MPL)

Job Summary

Seeking a highly skilled and experienced Complex Claims Specialist to join a dynamic and growing claims team. This individual will be responsible for managing Miscellaneous Professional Liability (MPL) claims from inception to resolution, including negotiation and settlement. The role requires a proactive approach to claims handling, collaboration with internal and external stakeholders, and the ability to mentor and guide other team members.

Compensation Package

• Salary Range:
  • $125,000 - $155,000 (Boston, Manhattan, West Hartford) + Bonus
  • $125,000 - $135,000 (Chicago, Atlanta) + Bonus
• Comprehensive benefits package, including:
  • 401(k) with competitive company matching

Responsibilities

• Manage and resolve complex to severe MPL claims, including all phases of litigation.
• Draft complex coverage letters, such as reservation of rights and denial letters, with minimal supervision.
• Review and analyze claim documentation and legal filings.
• Lead defense strategies on litigated files and drive litigation best practices.
• Mentor and train claims examiners to enhance team capabilities.
• Investigate, negotiate, and utilize alternative dispute resolutions to achieve positive claim outcomes.
• Identify emerging exposures, claims trends, and suspected fraudulent claims.
• Maintain accurate and compliant documentation of claim files.
• Develop and deliver training content for claims team and underwriters.

Qualifications/Requirements

• 8+ years of claims handling experience or 7-8 years of litigation experience. (A JD from an ABA-accredited law school may be considered as a supplement to claims handling experience.)
• Proven ability to positively influence complex claims outcomes through investigation, negotiation, and litigation leadership.
• Advanced knowledge of coverage within the MPL specialty or focus.
• Strong understanding of litigation processes and negotiation strategies.
• Experience mentoring and training claims professionals.
• Excellent verbal and written communication skills.
• Advanced analytical and problem-solving abilities.
• Bachelor’s degree from an accredited college or university preferred.

#LI-BC1

Senior Complex Claims Specialist (MPL)

Job Summary

Seeking a highly skilled and experienced Senior Complex Claims Specialist to join a dynamic and innovative Claims team. This role is an individual contributor position responsible for managing Miscellaneous Professional Liability (MPL) claims from inception to resolution. The successful candidate will handle mid to high-severity claims, negotiate settlements, and collaborate with internal and external stakeholders to achieve optimal outcomes.

Compensation Package

• Salary Range:
  • $150,000 - $160,000 (Boston, Manhattan, West Hartford) + Bonus
  • $125,000 - $135,000 (Chicago, Atlanta) + Bonus
• Comprehensive benefits package, including:
  • 401(k) with competitive company matching

Responsibilities

• Manage and resolve high-severity Miscellaneous Professional Liability claims from inception to resolution.
• Draft complex technical coverage analyses and correspondence.
• Act as a subject matter expert within the claims team.
• Lead litigation strategies, including attending and managing trials and mediations.
• Investigate, negotiate, and utilize alternative dispute resolution methods to achieve positive claim outcomes.
• Identify and address emerging exposures and claims trends.
• Collaborate with external and internal stakeholders, including legal counsel and underwriters.
• Mentor and provide guidance to other team members.
• Develop and deliver training content for claims team and underwriters.
• Maintain accurate and compliant claim documentation.

Qualifications/Requirements

• Minimum of 10 years of claims handling experience.
• A Juris Doctor (JD) from an ABA-accredited law school may supplement claims handling experience.
• Proven ability to manage and resolve high-severity claims effectively.
• Expert knowledge of Miscellaneous Professional Liability coverage and litigation processes.
• Strong negotiation and analytical skills.
• Demonstrated ability to mentor and train team members.
• Excellent verbal and written communication skills.
• Bachelor’s degree from an accredited college or university preferred.
• Adjuster licensing required or ability to obtain within 90 days of employment.

#LI-BC1

Senior Complex Claims Specialist (Professional Liability)

Job Summary

Seeking a highly skilled and experienced Senior Complex Claims Specialist to join a dynamic and innovative Claims team. This role involves managing high-severity primary Professional Lines claims, including Miscellaneous Professional Liability, A&E, Allied Health, and Media claims, from inception to resolution. The successful candidate will play a pivotal role in shaping insurance products, collaborating with business leaders, and providing technical support to the claims team. This is a hybrid position requiring in-office presence two days per week.

Compensation Package

• Salary Range:
  • $150,000 - $160,000 (Boston, Manhattan, West Hartford) + Bonus
  • $125,000 - $135,000 (Chicago, Atlanta) + Bonus
• Benefits Include:
  • 401(k) with competitive company matching

Responsibilities

• Manage high-severity Professional Liability claims, including investigation, negotiation, and resolution.
• Draft complex technical coverage analyses and correspondence.
• Act as a subject matter expert within the claims team.
• Model best practices for litigation and ensure file integrity.
• Utilize alternative dispute resolution methods and identify cases for trial when necessary.
• Identify and address emerging exposures and claims trends.
• Collaborate with internal and external stakeholders, including underwriters, legal counsel, and external experts.
• Mentor and provide training to team members, contributing to their professional development.
• Develop and deliver training content for claims teams and underwriters.
• Maintain accurate and compliant documentation of claim files.

Qualifications/Requirements

• Minimum of 10 years of experience in Professional Liability and/or Specialty claims handling.
• Bachelor’s degree required; JD from an ABA-accredited law school is preferred.
• Proven ability to manage high-severity claims and achieve positive outcomes through investigation, negotiation, and litigation.
• Expert knowledge of Professional Liability coverage and litigation processes.
• Strong analytical, verbal, and written communication skills.
• Demonstrated ability to mentor and train team members.
• Ability to work effectively in a fast-paced and dynamic environment.
• Must obtain adjuster licensing within 90 days of employment.

#LI-BC1

GL Bodily Injury Adjuster

Job Summary

Seeking a skilled and experienced GL Bodily Injury Adjuster to join a team in a hybrid role. This position involves analyzing and processing insurance claims to determine the extent of liability while adhering to state Department of Insurance regulations. The ideal candidate will have a strong background in handling moderate to severe complexity third-party bodily injury and property damage claims, both litigated and non-litigated. This role requires excellent communication, analytical, and negotiation skills, as well as a commitment to delivering exceptional service to clients.

Compensation Package

• Competitive salary: $75,000 - $100,000 annually
• Performance-based bonus opportunities
• Comprehensive benefits package, including:
  • Company match on 401(k)

Responsibilities

• Investigate and resolve moderate to severe complexity third-party bodily injury and property damage claims.
• Handle both litigated and non-litigated claims, ensuring compliance with state Department of Insurance regulations.
• Document claims files with findings from investigations, evaluate liability, and negotiate settlements.
• Prepare releases, reservation of rights letters, and denials of liability.
• Compile large loss reports for claims involving severe injuries.
• Maintain open communication and build rapport with clients, claimants, attorneys, and other stakeholders.
• Provide coaching and mentoring to less experienced team members.

Qualifications/Requirements

• Minimum of 5+ years of multi-line claims handling experience at an insurer or TPA.
• Proven expertise in liability claims, including premises liability and complex bodily injury claims.
• Strong knowledge of commercial lines coverage and exposure.
• Experience with files in litigation and effective communication skills.
• Industry certifications such as CPCU, AIC, or SCLA are highly desirable.
• Must possess a Florida State Adjuster’s License and be able to secure and maintain a multi-state adjuster license.
• High school diploma or equivalent (GED) required; additional education or training is a plus.
• Excellent verbal and written communication, investigation, organization, and analytical skills.
• Ability to work independently and handle complex issues with minimal supervision.

#LI-RG1

GL Bodily Injury Adjuster

Job Summary

Seeking a skilled and experienced GL Bodily Injury Adjuster to join a team. Reporting to the Supervisor of Liability Claims, this role involves analyzing and processing insurance claims to determine the extent of liability while adhering to company standards, values, and state regulations. The ideal candidate will handle moderate to severe complexity third-party bodily injury and property damage claims, ensuring efficient adjudication and resolution of both litigated and non-litigated cases.

Compensation Package

• Salary Range: $75,000 - $110,000 annually

Responsibilities

• Investigate and resolve moderate to severe complexity third-party bodily injury and property damage claims.
• Handle both litigated and non-litigated claims, ensuring timely and efficient resolution.
• Document claims files with findings from investigations, evaluate liability, and negotiate settlements.
• Prepare releases, reservation of rights letters, and denials of liability.
• Compile large loss reports for claims involving severe injuries.
• Maintain compliance with state Department of Insurance regulations for claims files.
• Foster strong relationships and maintain open communication with clients, insureds, claimants, attorneys, and other stakeholders.

Qualifications/Requirements

• Minimum of 5+ years of multi-line claims handling experience at an insurer or TPA.
• At least 5+ years of experience working in liability claims.
• Expertise in premises liability claims and injury evaluation.
• Proven experience handling complex bodily injury claims.
• Industry certifications such as CPCU, AIC, SCLA, or other related training or coursework preferred.
• Possession of a NYS claims adjuster license and other state adjusting licenses is highly desirable.
• Strong verbal and written communication, investigation, organizational, and analytical skills.
• Comprehensive knowledge of commercial lines coverage and exposure.
• Demonstrated decision-making, judgment, and negotiation skills.
• Experience managing litigation files and effective communication with legal teams.
• Ability to work independently with minimal supervision.
• Capability to handle complex issues and provide coaching or mentoring to less experienced team members.

#LI-RG1