Workers' Compensation Claims Adjuster

ProService Hawaii is looking for a Workers' Compensation Claims Adjuster to own the full lifecycle of assigned indemnity claims — from first report through resolution. This is a high-visibility, client-facing role where you're trusted to make sound decisions, manage costs responsibly, and move claims forward with urgency and discipline. What makes this role distinct from a traditional carrier environment is the level of ownership expected. Our adjusters operate in a highly visible, client-facing model every file is yours, and your results are visible. IN THIS ROLE YOU WILL Manage a full caseload of approximately 90–100 active indemnity/lost time claims, driving each toward timely and cost-effective resolution Conduct thorough investigations, determine compensability, establish accurate reserves within 48 hours of assignment, and document clear, forward-looking claim strategies Actively manage medical treatment plans using evidence-based guidelines (ODG), initiate IMEs when appropriate, and coordinate return-to-work and vocational strategies to reduce indemnity duration Ensure strict compliance with Hawaii workers' compensation statutes, regulatory deadlines, and benefit payments — maintaining zero missed deadlines and audit-ready files Prepare for and represent employer/carrier at hearings before the Hawaii DLIR, Disability Compensation Division Communicate proactively with employers, injured workers, attorneys, and medical providers — setting expectations early, explaining decisions clearly, and managing escalations with composure and authority What You'll Bring To The Team We don't measure candidates by resume alone. We're looking for people who hold themselves to a standard most don't, take feedback as fuel, and are wired to own their results. Proven success managing full-cycle workers' compensation claims, including indemnity and litigated files, is required. You've managed full-cycle indemnity claims and can point to outcomes you drove. You've owned compensability decisions, defended reserve strategies, and guided complex files to resolution — and you can speak to the judgment calls you made along the way. You know Hawaii WC statutes and apply them with confidence. Statutory timelines, hearing procedures, compliance requirements — these aren't things you look up every time. You stay current and flag risks before they become problems. You analyze medical documentation and push back when the evidence doesn't support the claim. You apply ODG and other treatment guidelines with credibility, challenge unsupported care, and know when an IME is the right move. Your files tell the full story. Your documentation doesn't just record what happened — it captures your rationale, your strategy, and your next steps. Audit-ready is your baseline. You maintain composure and professionalism under pressure. Difficult claimants, frustrated employers, opposing counsel — you manage those interactions with clarity and professionalism. IS THIS ROLE RIGHT FOR YOU? We want you to walk in with clear eyes, so here's an honest look at what this role is — and what it isn't. This is a full-cycle indemnity claims role in a metrics-driven environment where performance standards are high and results are tracked closely. You'll be expected to manage a caseload of 90–100 active files, maintain a 1:1 or better new-to-closure ratio, and keep every diary current — all while staying ahead of statutory deadlines and delivering a strong client experience. You'll be given real responsibility and the room to exercise it — setting strategy, making decisions, and moving claims forward on your own terms within a team that supports your success. WORK LOCATION Hawaii Kai, Oahu — Hybrid This role is based out of our Hawaii Kai office. We offer a flexible hybrid schedule that gives you the structure of in-person collaboration with the flexibility of remote work. In office: Tuesday – Thursday | Remote: Monday & Friday In office: Tuesday – Thursday | Remote: Monday & Friday Compensation The base compensation for this position is $76,000.00 – $98,000.00 per year depending on experience and qualifications. WHY PROSERVICE ProService is a Hawaii-based PEO combining payroll, HR, and benefits expertise with purpose-built technology — all backed by the best local service in Hawaii. Backed by Silver Lake and recognized as one of Hawaii’s Best Places to Work for 20 consecutive years, we’re a team of high performers united by one mission: Empowering Employers to Succeed in Hawaii. A PROhana unlike any other. We assume the best in each other, give feedback focused on what’s right—not who’s right—and show up every day. This isn’t just a workplace. It’s a community. Do work that matters. You’ll see exactly how your contributions move the needle—meaningful problems, real decisions, and a seat at the table. Grow without a ceiling. Internal roles post first, and we reimburse certifications, conferences, and memberships. Your growth is our growth. Compete, collaborate, and win together. High expectations, real accountability, and a team of experts ready to help you push through any obstacle. Total rewards built around your whole life. Fully paid healthcare, 401(k) matching, paid parental leave, student loan assistance, employee assistance programs, and paid time off—just to name a few. #J-18808-Ljbffr