- Salary
- $70k – $75k/yr
- Location
- Home United States
- Workplace
- Remote
- Type
- Full-time
- Department
- Human Resources
- Source
- Pinpoint
Description
Workers' Compensation Lost Time Adjuster (Remote)
Department: Claims Administration & Adjusting
Employment Type: Permanent - Full Time
Location: Home United States
Reporting To: Sonia Ayunta
Compensation: $70,000 - $75,000 / year
Description
Our Story
Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.
What's in Store
We are seeking a Workers’ Compensation Lost Time Claims Adjuster to investigate, evaluate, and manage Workers’ Compensation claims while delivering timely, cost-effective resolutions and exceptional client service.
This role manages claims of increasing complexity based on level, including moderate to complex losses, litigated matters, and catastrophic exposures. The adjuster develops and executes strategic action plans to ensure claims are resolved appropriately, efficiently, and in compliance with jurisdictional requirements.
Key Responsibilities
- Own the full lifecycle of Workers’ Compensation claims, from initial investigation through resolution
- Determine compensability and coverage with confidence and accuracy
- Conduct detailed investigations, including interviews and evidence gathering
- Analyze medical, legal, and employment documentation to guide decision-making
- Manage EDI reporting and ensure CMS Section 111 compliance
- Develop and execute strategic claim plans for complex and litigated files
- Partner with defense counsel to drive effective litigation strategies and control costs
- Negotiate settlements with claimants and attorneys to achieve optimal outcomes
- Handle catastrophic and high-severity claims with care and precision
- Leverage preferred vendors and cost-containment tools effectively
- Deliver clear, insightful reporting to clients and excess carriers
- Maintain strong client relationships through responsive, professional communication
- Stay current on jurisdictional requirements, trends, and best practices
- Support team development through mentorship and knowledge sharing
Skills, knowledge & expertise
- 3+ years of Workers’ Compensation claims handling experience
- Experience with lost time claims, compensability analysis, and claim strategy preferred
- Active adjuster licenses as required by jurisdiction (or ability to obtain)
- Direct experience handling Workers’ Compensation claims (level‑dependent)
- Knowledge of Workers’ Compensation laws and jurisdictional requirements
- Understanding of medical terminology and its impact on claim exposure
- Strong investigation, analysis, and decision‑making skills
- Effective negotiation and communication abilities
- Ability to manage multiple priorities in a fast‑paced environment
- Proficiency with claims systems and related technology
- Professionalism in handling sensitive or confidential information
Equal Employment Opportunity & Legal Notices
Benefits
At Davies North America, we are dedicated to supporting the well‑being and future of our qualifying employees. Our comprehensive benefits package includes:
- Medical, dental, and vision plans to support your health and that of your family
- A 401(k) plan with employer matching
- Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees
- Paid holidays
- Life insurance and short‑term and long‑term disability coverage
Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee’s primary work location.
Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.
Diversity and Inclusion
Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.
Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.
Essential Functions
The following responsibilities and expectations are considered essential to the successful performance of this role. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform these essential functions.
Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.
Essential Functions
The following responsibilities and expectations are considered essential to the successful performance of this role. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform these essential functions.
- Maintain regular and dependable attendance.
- Be available and able to perform job responsibilities during established work hours.
Background Check & Fair Chance Compliance
Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair‑chance hiring requirements.
Massachusetts Notice
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Massachusetts Notice
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
AI Policy
At Davies, we value authentic conversations and a fair candidate experience. While candidates may use AI and technology tools to prepare for interviews, we expect interview responses and assessments to reflect each individual's own experience, knowledge, and professional judgment.
We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at [email protected]
Skills
ComplianceNegotiation
