Workers' Compensation Claims Adjuster

TL;DR

Workers' Compensation Claims Adjuster (Insurance): Investigating and managing Florida Workers' Compensation claims with an accent on evaluating compensability, setting reserves, and ensuring compliance with state statutes and case law. Focus on coordinating medical treatment, managing litigated issues, and maintaining high claim closure ratios in a fast-paced environment.

Location: Must be based in the United States (Florida focus)

Salary: $80,000 - $85,000 / year

Company

A specialist professional services and technology firm partnering with global insurance and highly regulated businesses to manage risk and transform core operations.

What you will do

• Evaluate claim details and Florida Statute/case law to determine compensability and set appropriate reserves.
• Initiate investigations, assign defense counsel, and manage litigated issues.
• Coordinate medical treatment with Nurse Case Managers and authorize services per Florida Statute 440.13.
• Handle indemnity payments, state filings, and EDI rejections accurately.
• Monitor vocational rehabilitation needs and coordinate light duty availability with employers.
• Maintain a 97% claim closure ratio while ensuring client satisfaction.

Requirements

• 3-5 years of Lost Time/Legal claims handling experience (5+ years preferred).
• Must possess a valid FL-All Lines Adjuster or Workers’ Compensation License.
• Strong knowledge of Florida Workers’ Compensation Statutes and Rules.
• Proficiency in Microsoft Office Suite and claims management software.
• Excellent communication, time management, and multi-tasking skills.
• Ability to work independently and collaboratively in a fast-paced environment.

Culture & Benefits

• Comprehensive medical, dental, and vision insurance plans.
• 401(k) plan with employer matching.
• Generous time-off policies including DTO/PTO and paid holidays.
• Life insurance and short/long-term disability coverage.
• Commitment to diversity, inclusion, and professional development.