Senior Workers' Compensation Claims Adjuster (Insurance)

TL;DR

Senior Workers' Compensation Claims Adjuster (Insurance): Managing complex workers' compensation claims from inception to resolution with an accent on litigation management, catastrophic loss handling, and regulatory compliance. Focus on developing strategic action plans, conducting thorough investigations, and ensuring timely outcomes for clients and stakeholders.

Location: Must be based in New Mexico and able to support hybrid in-office work as needed.

Compensation: $85,000–$92,000 per year.

Company

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

What you will do

• Investigate and evaluate claims to determine coverage, compensability, and liability.
• Develop and implement strategic action plans for claim resolution.
• Negotiate settlements with claimants and legal representatives.
• Oversee litigation activities and ensure effective cost control.
• Manage EDI reporting and CMS/Section 111 compliance requirements.
• Mentor team members and share expertise on complex claim scenarios.

Requirements

• Active New Mexico Adjuster License required.
• 5–7 years of experience handling workers’ compensation claims, including complex files.
• Bachelor’s degree or equivalent combination of education and professional experience.
• Strong understanding of medical terminology and legal concepts.
• Ability to work independently and collaboratively in a hybrid environment.
• Proficiency with claims management systems and standard business software.

Culture & Benefits

• Comprehensive medical, dental, and vision plans.
• 401(k) plan with employer matching.
• Paid time-off policies and paid holidays.
• Life insurance and disability coverage.
• Commitment to a diverse and inclusive workplace.