workers compensation claims adjuster

The Black Car Fund

<p><b>Join Our Team at The Black Car Fund: New York Workers' Compensation Claims Adjuster</b></p><p>Hybrid (Long Island City, NY) or Fully Remote (for candidates living in New York State and 75 miles or more from Long Island City)<br/><b>$85,000 &ndash; $110,000 + $2,500 Signing Bonus</b></p><p><b>Make an Impact on Where It Matters</b></p><p>At <b>The Black Car Fund</b>, we don&rsquo;t just manage claims, we support the drivers who keep New York moving. As a not-for-profit dedicated to providing workers&rsquo; compensation insurance, safety education, and benefits to For-Hire drivers, our work directly affects thousands of lives every day.</p><p>We&rsquo;re looking for an experienced <b>New York Workers&rsquo; Compensation Claims Adjuster</b> who is both detail-driven and people-focused, someone who takes pride in managing claims effectively while delivering meaningful outcomes.</p><p><b>Why This Role Stands Out:</b></p><ul><li><b>Mission-driven work</b> that supports essential workers</li><li><b>Flexible work environment</b> (hybrid <i>or</i> fully remote)</li><li><b>Competitive compensation + signing bonus</b></li><li><b>Some opportunity for growth</b> within a collaborative, forward-thinking team</li></ul><p><b>What You&rsquo;ll Do:</b></p><p>As a key member of our Claims team, you&rsquo;ll take full ownership of your caseload, from intake through resolution, while making informed decisions that balance compliance, care, and cost.</p><p><b>Key responsibilities include:</b></p><ul><li>Evaluate new claims for compensability, including making 3-point contacts</li><li>Manage both medical and indemnity components of claims</li><li>Evaluate and set reserves</li><li>Coordinate Independent Medical Examinations (IMEs)</li><li>Review medical bills and authorize payments utilizing the NY Medical Treatment Guidelines</li><li>Guide assistant team members on EDI form completion</li><li>Represent cases at hearings when required</li><li>Partner with internal teams and external vendors</li><li>Develop and execute strategic Plans of Action for each claim</li><li>Negotiate and settle claims when appropriate</li><li>Maintain thorough, accurate documentation</li><li>Stay current on industry through training and seminars</li><li>Contribute to special projects and team initiatives</li></ul><p><b>What You Bring:</b></p><p>You&rsquo;re a proactive professional who thrives in a fast-paced environment and knows how to balance technical expertise with sound judgment.</p><p><b>Required:</b></p><ul><li>4+ years of Workers&rsquo; Compensation Claims Adjusting experience</li><li>Strong knowledge of New York workers&rsquo; compensation laws and regulations</li><li>Familiarity with medical and legal terminology related to injury claims</li><li>Understanding of claims-related financial processes and documentation</li><li>Proficiency with modern office systems and claims platforms</li></ul><p><b>What Sets You Apart:</b></p><ul><li>Strong negotiation and analytical skills</li><li>Ability to work independently while collaborating effectively</li><li>Highly organized with a solutions-oriented mindset</li><li>Clear communicator, both speaking and writing, with a strong attention to detail</li></ul><p>If you're looking for a role where your expertise truly makes a difference, and where flexibility, purpose, and professional growth come together, we&rsquo;d love to hear from you.</p><p><b>Why You&rsquo;ll Love Working with Us:</b></p><p>We&rsquo;re committed to creating a supportive, rewarding, diverse environment where your contributions truly matter. Here&rsquo;s what you can expect as a member of our team:</p><ul><li><b>Competitive Salary</b>: $85,000 - $110,000 per year.</li></ul><p><b>Generous Benefits</b>:</p><ul><li><b>Health Care Benefits</b> with limited employee contribution. One of our health plans requires no contribution. All plans cover eligible family members at similar rates.</li><li><b>401(k) with 100% employer match</b> (up to 6% of salary).</li><li><b>ROTH 401(k)</b></li><li><b>100% employer-paid Life Insurance</b>, <b>Dental</b>, and <b>Vision coverage</b>.</li><li><b>Paid Vacation &amp; Sick Time</b>, plus <b>Pre-tax Transit Benefits</b>.</li><li><b>Flexible Spending Account</b> allows you to use pre-tax monies to pay unreimbursed medical and dependent care expenses.</li><li><b>Lifestyle Spending Account </b>allows you to use pre-tax monies for expenses incurred in a wide variety of categories, including sports equipment, utility bills, and auto expenses.</li><li><b>Pet Discount Program</b> covers any pet, regardless of breed, health, or age!</li><li><b>Employee Assistance Plan </b>available on a confidential basis.</li><li><b>$2500 Signing Bonus</b> to welcome you to the team!</li><li><b>Work-Life Balance</b>: <i>Hybrid work schedule after training.</i></li><li><b>Team-Oriented Culture</b>: We foster a collaborative environment with opportunities for growth through team-building exercises and training.</li><li><b>Career Growth Opportunities</b>: The Black Car Fund supports your professional development through ongoing education and skills training.</li></ul><p><b>Qualifications &amp; Requirements:</b></p><ul><li><b>Education</b>: College degree preferred.</li><li><b>Experience</b>: 4+ years of experience as a NYS Workers' Compensation Claims Adjuster.</li><li><b>Location</b>: Hybrid remote position based in Long Island City, NY. Those who live beyond a 75-mile radius of Long Island City and live in New York, New Jersey, or Connecticut are eligible to work from home.</li></ul><p><b>Who Should Apply:</b></p><p>The Black Car Fund is an <b>equal-opportunity employer,</b> and we strongly encourage <b>military veterans and spouses</b> to apply. We value diversity and are committed to creating an inclusive work environment where everyone can thrive.</p><p>If you're ready to bring your skills, enthusiasm, and passion to a meaningful role, apply now to join our team at The Black Car Fund, one of the Top Places to Work in New York by City &amp; State New York, and named one of the Best Companies to Work For in New York in 2026 by Best Companies Group!</p><p>Pay: $85,000.00 - $110,000.00 per year</p><p>Benefits:</p><ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Professional development assistance</li><li>Referral program</li><li>Vision insurance</li></ul><p>People with a criminal record are encouraged to apply</p><p>Experience:</p><ul><li>Workers' compensation claims adjusting: 4 years (Required)</li></ul><p>Work Location: Hybrid remote in Long Island City, NY 11101</p>

Workers' Compensation Claims Adjuster

TEEMA Group

<div><p>We are seeking an experienced <b>Texas Workers&rsquo; Compensation Claims Adjuster</b> to join our team at our Irving, TX office. This role is primarily <b>in-office, five days per week</b>, with <b>limited hybrid flexibility</b> considered only for highly experienced adjusters who live farther from the office and have a proven ability to independently manage Texas claims.</p><p>
This position requires strong technical knowledge of Texas Workers&rsquo; Compensation laws, confidence attending hearings, and the ability to manage a full caseload with minimal oversight.</p><p></p><h3 class="jobSectionHeader"><b>
Key Responsibilities</b></h3><ul><li><p>
Manage a full caseload of <b>Texas Workers&rsquo; Compensation claims</b> from inception through resolution</p></li><li><p>
Investigate claims, analyze coverage, determine compensability, and establish reserves</p></li><li><p>
Communicate effectively with injured workers, employers, medical providers, and legal representatives</p></li><li><p>
Prepare for and <b>attend Workers&rsquo; Compensation hearings as required</b></p></li><li><p>
Ensure compliance with Texas Workers&rsquo; Compensation laws, regulations, and internal guidelines</p></li><li><p>
Maintain accurate and timely documentation within claims management systems</p></li><li><p>
Provide high-quality customer service while balancing cost containment and fair claim resolution</p></li></ul><p></p><h3 class="jobSectionHeader"><b>
Work Schedule &amp; Location</b></h3><ul><li><p><b>
Primary expectation: In-office, 5 days per week</b></p></li><li><p><b>
Hybrid consideration</b> may be given based on:</p><ul><li><p>
Distance from the Irving office</p></li><li><p>
Depth of Texas Workers&rsquo; Comp experience</p></li><li><p>
Demonstrated ability to manage claims independently</p></li></ul></li><li><p>
Candidates commuting <b>1 hour or more</b> may be considered for hybrid <b>only if experience level supports it</b></p></li></ul><p></p><h3 class="jobSectionHeader"><b>
Required Qualifications</b></h3><ul><li><p><b>
Active Texas Workers&rsquo; Compensation Adjuster License</b></p><ul><li><p>
Must provide license number and expiration date</p></li></ul></li><li><p><b>
Minimum 3 years of experience</b> handling Texas Workers&rsquo; Compensation claims</p><ul><li><p><b>
5+ years strongly preferred</b></p></li></ul></li><li><p>
Proven experience managing hearings and complex claims</p></li><li><p>
Strong written, verbal, and organizational skills</p></li><li><p>
Ability to work effectively in an in-office team environment</p></li></ul><p>
If you would like to apply email your resume</p><p>
mpalkin@teemagroup.com</p><p></p>
#Workwolf</div>

Workers’ Compensation Claims Adjuster (Texas)

Argo Group

<div><p><b>Company
</b></p>Argo Group
<p></p><p>Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc.<br>
</p><p><br>
<b>Job Description
</b></p><p></p><div><div><p><b>Business Title(s): </b>TEMP <b>- </b>Workers&rsquo; Compensation Claims Adjuster
</p></div><div><p><b>Employment Type: </b>Contingent Worker
</p></div><div><p><b>FLSA Status: </b>Non-E xempt
</p></div><div><p><b>Location: </b>In-Office or Remote<br>
<br>
</p></div><div><p><b>Summary:
</b><br>
We are looking for a highly capable Workers' Compensation Claims Adjuster to help us on a temporary assignment with an estimated end date of May 29, 2026, and can work from anywhere in the United States. If this role is filled so the individual can work five days a week in any of the following offices, we can consider this a temp-to-hire assignment: Albany (NY), Chicago (IL), Houston (TX), Los Angeles (CA), New York City (NY), Omaha (NE), Richmond (VA), Rockwood (PA), or Springfield (MO) . This role will adjudicate indemnity workers' compensation claims of higher technical complexity for our customers in the states of AZ and CA . As this is a temporary assignment, only government mandated benefits will be provided.<br>
<br>
</p></div><div><p>Employees in this role are required to accurately record all hours worked and submit timesheets in accordance with company policy. Overtime may be assigned as business needs dictate , and employees are expected to work overtime when required .<br>
<br>
</p></div><div><p><b>Essential Responsibilities </b><b>:
</b></p></div><div><ul><li><p>Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results.
</p></li></ul></div><div><ul><li><p>Resolving issues that are generalized and typically not complex, but require understanding of a broader set of issues.
</p></li></ul></div><div><ul><li><p>Reporting to senior management and underwriters on claims trends and developments.
</p></li></ul></div><div><ul><li><p>Investigating claims promptly and thoroughly.
</p></li></ul></div><div><ul><li><p>Analyzing claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage.
</p></li></ul></div><div><ul><li><p>Investigating claims promptly and thoroughly, including interviewing all involved parties.
</p></li></ul></div><div><ul><li><p>Managing claims in litigation.
</p></li></ul></div><div><ul><li><p>Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
</p></li></ul></div><div><ul><li><p>Properly setting claim reserves.
</p></li></ul></div><div><ul><li><p>Identifying , assigning, and coordinating the assignment and coordination of expertise resources to assist in case resolution.
</p></li></ul></div><div><ul><li><p>Preparing reports for file documentation.
</p></li></ul></div><div><ul><li><p>Applying creative solutions which result in the best financial outcome.
</p></li></ul></div></div><div><div><ul><li><p>Negotiating settlements.
</p></li></ul></div><div><ul><li><p>Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.).
</p></li></ul></div><div><ul><li><p>Having an appreciation and passion for strong claim management.<br>
<br>
</p></li></ul></div><div><p><b>Qualifications / Experience Required:
</b></p></div><div><ul><li><p>A practical knowledge of adjudicating workers' compensation claims through:
</p></li></ul></div><div><ul><li><p>A minimum of five years&rsquo; experience adjudicating workers' compensation claims in one or more of the following jurisdictions : AZ and CA.
</p></li></ul></div><div><ul><li><p>Bachelor&rsquo;s degree from an accredited university required . Two or more insurance designations or four additional years of related experience adjudicating indemnity claims beyond the minimum experience required above may be substituted in lieu of a degree.
</p></li></ul></div><div><ul><li><p>CA Self-Insurance certification required
</p></li></ul></div><div><ul><li><p>Must have good business acumen ( i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers&rsquo; ability to be profitable).
</p></li></ul></div><div><ul><li><p>Must have excellent communication skills and the ability to build lasting relationships.
</p></li></ul></div><div><ul><li><p>Exhibit natural curiosity
</p></li></ul></div><div><ul><li><p>Desire to work in a fast-paced environment.
</p></li></ul></div><div><ul><li><p>Excellent evaluation and strategic skills required .
</p></li></ul></div><div><ul><li><p>Strong claim negotiation skills a must .
</p></li></ul></div><div><ul><li><p>Must possess a strong customer focus.
</p></li></ul></div><div><ul><li><p>Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
</p></li></ul></div><div><ul><li><p>Ability to articulate the financial value of your work at multiple responsibility levels inside our clients&rsquo; business which may include CEO.
</p></li></ul></div><div><ul><li><p>Must work independently and demonstrate the ability to exercise sound judgment.
</p></li></ul></div><div><ul><li><p>Demonstrates inner strength. Has the courage to do the right thing and demonstrates it on a daily basis.
</p></li></ul></div><div><ul><li><p>Intellectual curiosity. Consistently considers all options and is not governed by conventional thinking.
</p></li></ul></div></div><div><div><ul><li><p>Proficient in MS Office Suite and other business-related software.
</p></li></ul></div><div><ul><li><p>Polished and professional written and verbal communication skills.
</p></li></ul></div><div><ul><li><p>The ability to read and write English fluently is required .
</p></li></ul></div><div><ul><li><p>Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.<br>
<br>
</p></li></ul></div><div><p>The base salary range provided below is for hires in those geographic areas only and will be commensurate with candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, all employees are eligible for an annual bonus based on company and individual performance as well as a generous benefits package.
</p></div><div><ul><li><p><b>Colorado outside of Denver metro, Maryland, Nevada, and Rhode Island Pay Ranges: </b>$ 30.89 - $44.33 per hour
</p></li></ul></div><div><ul><li><p><b>California outside of Los Angeles, San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, Washington State, and New York State (including Westchester County) Pay Ranges: </b>$ 34.03- $48.79 per hour
</p></li></ul></div><div><ul><li><p><b>Los Angeles, New York City and San Francisco metro areas Pay Ranges: </b>$ 37.12 - $49.18 per hour<br>
<br>
</p></li></ul></div><div><p><b>About Working in Claims at Argo Group
</b></p></div><div><ul><li><p>Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.
</p></li></ul></div><div><ul><li><p>Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is.<br>
<br>
</p></li></ul></div><div><ul><li><p>We have a very flat organizational structure, enabling our employees have more interaction with our senior management team, especially when it relates to reviewing large losses.<br>
<br>
</p></li></ul></div><div><ul><li><p>Our entire claims team works in a collaborative nature to expeditiously resolve claims. We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas.<br>
<br>
</p></li></ul></div><div><ul><li><p>We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.<br>
</p></li></ul></div></div><p></p><div><p><b><i>PLEASE NOTE:
</i></b></p><p>Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.
</p><p></p><p>If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at 210-321-8400.
</p><p></p><p><b>Notice to Recruitment Agencies:
</b><br>
Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited. BWS and / or its affiliates will not be responsible for any fees associated with unsolicited submissions.
</p><p></p><p>We are an Equal Opportunity Employer. We do not discriminate on the basis of age, ancestry, color, gender, gender expression, gender identity, genetic information, marital status, national origin or citizenship (including language use restrictions), denial of family and medical care leave, disability (mental and physical) , including HIV and AIDS, medical condition (including cancer and genetic characteristics), race, religious creed (including religious dress and grooming practices), sex (including pregnancy, child birth, breastfeeding, and medical conditions related to pregnancy, child birth or breastfeeding), sexual orientation, military or veteran status, or other status protected by laws or regulations in the locations where we operate. We do not tolerate discrimination or harassment based on any of these characteristics.
</p><p></p><p>The collection of your personal information is subject to our HR Privacy Notice
</p><p></p><p><b>Benefits and Compensation
</b></p><p>We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program&mdash;including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.</p></div></div><p></p>

Workers' Compensation Claims Adjuster (CONTRACT)

Gallagher

<div><b>Introduction</b><br>
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div><br>
<b>Overview</b><br>
<ul><li><b>
Jurisdictions: California</b></li><li><b>
Licenses: An active CA Designation is required (up to date on CE hours). SIP optional.</b></li><li><b>
Location: </b>This role is eligible for fully remote work.</li></ul>
<br>
<b>How you'll make an impact</b><br>
<ul><li>
Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims.</li><li>
Interact extensively with various parties involved in the claim process to ensure effective communication and resolution.</li><li>
Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process.</li><li>
Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements.</li><li>
Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file.</li></ul>
<br>
<b>About You</b><ul><li><br>
<b>Claims Background: </b>Minimum of 3-5 years of hands on workers compensation adjusting experience including handling a lost time/indemnity desk plus litigation.</li><li><b>Jurisdictional Experience:</b> California Workers Compensation</li><li><b>Active Adjusters' licenses</b>: CA Designation required. SIP optional.</li></ul><div></div><div><br>
As a key member of our experienced Claims Adjuster team, you will:</div><div></div><ul><li><br>
Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution.</li><li>Work in partnership with our clients to deliver innovative solutions and enhance the claims management process</li><li>Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants</li></ul><div></div><div><b><br>
REQUIRED QUALIFICATIONS:</b></div><ul><li>High School Diploma.</li><li>Minimum of 5 years related claims experience.</li><li>Appropriately licensed and/or certified in all states in which claims are being handled.</li><li>Knowledge of accepted industry standards and practices.</li><li>Computer experience with related claims and business software.</li></ul><div></div><div><b><br>
DESIRED:</b></div><ul><li>Bachelor's Degree</li></ul><div></div><div><br>
#LI-HS1</div><br>
<br>
<b>Compensation and benefits</b><p><br>
We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits.
</p><p>Below are the <b>minimum core benefits</b> you&rsquo;ll get, depending on your job level these benefits may improve:
</p><ul><li>Medical/dental/vision plans, which start from day one!</li><li>
Life and accident insurance</li><li>
401(K) and Roth options</li><li>
Tax-advantaged accounts (HSA, FSA)</li><li>
Educational expense reimbursement</li><li>
Paid parental leave</li></ul><div><b>
Other benefits include:</b></div><ul><li>
Digital mental health services (Talkspace)</li><li>
Flexible work hours (availability varies by office and job function)</li><li>
Training programs</li><li>
Gallagher Thrive program &ndash; elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing</li><li>
Charitable matching gift program</li><li>
And more...</li></ul><div><i>
**The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.</i></div><div></div><div><b><br>
We value inclusion and diversity</b></div><p>
Click Here to review our U.S. Eligibility Requirements</p><p>
Inclusion and diversity (I&amp;D) is a core part of our business, and it&rsquo;s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.
</p><p>Gallagher embraces our employees&rsquo; diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.</p><p>
Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as &ldquo;protected characteristics&rdquo;) by applicable federal, state, or local laws.
</p><p>Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.</p></div>

Senior Workers Compensation Claims Adjuster - California

Sedgwick

<div><p>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
</p><p></p><p>Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
</p><p>Certified as a Great Place to Work&reg;
</p><p>Fortune Best Workplaces in Financial Services &amp; Insurance
</p><p></p>Workers Compensation Claims Adjuster | Rancho Cucamonga, CA
<div><div>Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world&rsquo;s best brands?
</div></div><p></p><div><ul><li><p>Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</p></li><li><p>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</p></li><li><p>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</p></li><li><p>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</p></li><li><p>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</p></li><li><p>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</p></li><li><p>Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
</p></li></ul><p></p><p><b>ARE YOU AN IDEAL CANDIDATE? </b>We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
</p><p></p><p><b>OFFICE LOCATIONS
</b></p><p>Rancho Cucamonga, CA - Hybrid<br>
<br>
</p><p><b>PRIMARY PURPOSE OF THE ROLE: </b>To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.
</p><p></p><p><b>ESSENTIAL RESPONSIBLITIES MAY INCLUDE
</b></p><ul><li>Manages workers&rsquo; compensation claims, including determining compensability and benefits, developing action plans, monitoring reserve accuracy, and ensuring timely resolution in accordance with claim or client contracts.
</li></ul><ul><li>Processes and approves claim payments, coordinates return-to-work efforts, manages subrogation, and negotiates settlements.
</li><li>Communicates claim activity with claimants and clients while maintaining strong professional relationships.
</li><li>Ensures accurate claim documentation, coding, and required state and physician filings.
</li><li>May handle complex lifetime or defined-period medical claims, including utilization review treatment decisions.
</li></ul><p></p><p><b>QUALIFICATIONS
</b></p><p>Education &amp; Licensing: 4 years of claims management experience or equivalent combination of education and experience required.
</p><ul><li><p>High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
</p></li><li><p>Professional certification as applicable to line of business preferred.
</p></li></ul><p></p><p><b>Licensing / Jurisdiction Knowledge: California workers' compensation claims handling experience | SIP certified preferred
</b></p><p></p><p><b>TAKING CARE OF YOU
</b></p><ul><li><p>Flexible work schedule.
</p></li><li><p>Referral incentive program.
</p></li><li><p>Career development and promotional growth opportunities.
</p></li><li><p>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
</p></li></ul><p></p><p>As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $70,000-$80,000/yr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
</p><p></p><p>#claimsadjuster #claims #remote #LI-GC1 #LI-Remote
</p></div><p></p><p>Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles&rsquo; Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.
</p><p></p><p>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
</p><p></p><h2 class="jobSectionHeader"><b>If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</b></h2></div>

Workers Compensation Claims Adjuster | Rancho Cucamonga, CA

<div><b>Introduction</b><br>
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div><br>
<b>Overview</b><br>
<ul><li><b>
Jurisdictions: </b>IL, TN</li><li><b>
Licenses:</b> Must be licensed in states being handled or reciprocal</li><li><b>
Location: </b>This role is eligible for fully remote work.</li></ul>
<br>
<b>How you'll make an impact</b><br>
<ul><li>
Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims.</li><li>
Interact extensively with various parties involved in the claim process to ensure effective communication and resolution.</li><li>
Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process.</li><li>
Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements.</li><li>
Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file.</li></ul>
<br>
<b>About You</b><ul><li><br>
<b>Claims Background: </b>Minimum of 3-5 years of hands on workers compensation adjusting experience including handling a lost time/indemnity desk plus litigation.</li><li><b>Jurisdictional Experience:</b> Illinois, Tennessee Workers Compensation</li><li><b>Active Adjusters' licenses</b>: One of more active adjusters license required in states being handled or reciprocal</li></ul><div></div><div><br>
As a key member of our experienced Claims Adjuster team, you will:</div><div></div><ul><li><br>
Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution.</li><li>Work in partnership with our clients to deliver innovative solutions and enhance the claims management process</li><li>Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants</li></ul><div></div><div><b><br>
REQUIRED QUALIFICATIONS:</b></div><ul><li>High School Diploma.</li><li>Minimum of 5 years related claims experience.</li><li>Appropriately licensed and/or certified in all states in which claims are being handled.</li><li>Knowledge of accepted industry standards and practices.</li><li>Computer experience with related claims and business software.</li></ul><div></div><div><b><br>
DESIRED:</b></div><ul><li>Bachelor's Degree</li></ul><div></div><div><br>
#LI-HS1</div><div>
#LI-Remote</div><br>
<br>
<b>Compensation and benefits</b><p><br>
We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits.
</p><p>Below are the <b>minimum core benefits</b> you&rsquo;ll get, depending on your job level these benefits may improve:
</p><ul><li>Medical/dental/vision plans, which start from day one!</li><li>
Life and accident insurance</li><li>
401(K) and Roth options</li><li>
Tax-advantaged accounts (HSA, FSA)</li><li>
Educational expense reimbursement</li><li>
Paid parental leave</li></ul><div><b>
Other benefits include:</b></div><ul><li>
Digital mental health services (Talkspace)</li><li>
Flexible work hours (availability varies by office and job function)</li><li>
Training programs</li><li>
Gallagher Thrive program &ndash; elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing</li><li>
Charitable matching gift program</li><li>
And more...</li></ul><div><i>
**The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.</i></div><div></div><div><b><br>
We value inclusion and diversity</b></div><p>
Click Here to review our U.S. Eligibility Requirements</p><p>
Inclusion and diversity (I&amp;D) is a core part of our business, and it&rsquo;s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.
</p><p>Gallagher embraces our employees&rsquo; diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.</p><p>
Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as &ldquo;protected characteristics&rdquo;) by applicable federal, state, or local laws.
</p><p>Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.</p></div>

Senior Workers Compensation Claims Adjuster - IL, TN

Employers Insurance Group (EIG)

<div><p><b>Workers&rsquo; Compensation Claims Adjuster II - California | </b>100% Remote Opportunity
</p><p><b>General Summary
</b></p><p>The Work comp Claims Adjuster II is responsible for timely and accurate management of workers&rsquo; compensation claims with moderate medical and indemnity benefit exposure, including litigation.
</p><p>This opportunity will require working <b><i>west coast hours (M-F 8am-5pm PDT)
</i></b></p><p><b>Essential Duties and Responsibilities
</b></p><ul><li>Completes initial contacts to obtain necessary additional information, verify coverage, determine compensability and develop of plan of action. Completes and maintains accurate claim system data as it pertains to work comp insurance claims.
</li><li>Analyzes case facts to establish timely and accurate case reserves using knowledge of medical disabilities and related costs, as well as judgment of extent of disability.
</li><li>Provides timely and appropriate customer service within established best practices. Maintains ongoing professional communications with all internal and external customers.
</li><li>Accurately evaluates and pays benefits in compliance with statutory and company procedures and guidelines. Files appropriate state forms, as needed.
</li><li>Proactively coordinates and monitors medical treatment to continue to move the claim forward. Uses resources, internal and external, to contain costs and manage exposure.
</li><li>Reviews and analyzes legal exposures. Collaborates with defense attorneys to manage legal issues. Proactively mitigates exposure to litigation, prices up claims for settlement and works within authority to resolve claims.
</li><li>Regularly reviews caseload and proactively takes action to guide claims efficiently and effectively to closure.
</li><li>Other duties as assigned.</li></ul><br>
<p></p><p><b>Requirements
</b></p><ul><li>2 - 5 years&rsquo; work comp claims adjusting or insurance experience.
</li><li>Excellent communication and customer service skills and knowledge of an imaged environment.
</li><li>Demonstrated knowledge of workers&rsquo; compensation laws and ability to adhere to statutes, regulations and company policies and practices, as well as related claim management procedures/protocols.
</li><li>Self-motivated with excellent analytical, problem solving and decision-making skills. Strong ability to multi-task and prioritize.
</li><li>High school diploma or equivalent required.
</li><li>Equivalent combinations of education and experience may be considered.</li></ul><br>
<p></p><p><b>Certification
</b></p><ul><li>If state certification or license is required, must meet requirements and obtain certification within state mandated timeframe and maintain any required license through continuing education.
</li><li>WCCP, AIC, ARM, CPCU or other insurance certification preferred.</li></ul><br>
<p></p><p><b>Education
</b></p><ul><li>Bachelor&rsquo;s degree or equivalent business experience preferred.</li></ul><br>
<p></p><p><b>Work Environment
</b></p><ul><li>Remote: This role is a remote <b><i>(work from home (WFH) opportunity) </i></b>and only open to candidates currently located in the United States and able to work without sponsorship.
<ul><li>It requires a suitable space that provides a private and quiet workplace.
</li></ul></li><li>Expected Work Hours: Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.
</li><li>Travel: May be required to travel to off-site location(s) to attend meetings, as necessary
</li></ul><p><b>Salary Range: </b>$60,000-$85,000 and a strong comprehensive benefits package, don't forget to follow the link to our benefits page for details, too many benefits to list! EMPLOYERS Benefits</p><p><b><br>
</b></p><p><b>About EMPLOYERS
</b></p><p>As a dynamic, fast-growing provider of workers' compensation insurance and services, we are seeking a goal-oriented individual willing to put their ideas to work!
</p><p>We offer a positive, challenging work environment, combined with an opportunity to build your career as you help us grow our business, in innovative and imaginative ways that are uniquely EMPLOYERS!
</p><p>Headquartered in Nevada, EMPLOYERS attributes its long-standing success to its most valuable resource, our employees across the United States. EMPLOYERS is known for the quality service and expertise we provide to our clients, and the exemplary work environment we provide for our employees.
</p><p>We live and breathe our core values: Integrity, Customer Focus, Collaboration, Initiative, Accountability, Innovation, and Personal Fulfillment. These are the pillars that support how we do business with our clients as well as how we treat each other!
</p><p>At EMPLOYERS, you&rsquo;ll discover an energetic environment that inspires top achievement. As &ldquo;America&rsquo;s small business insurance specialist&rdquo;, we have the resources, a solid reputation and an expanding nationwide identity to enrich your work/life and enhance your career. #LI-Remote About EMPLOYERS</p></div>

Claims Adjuster II (workers' compensation) | California

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