Senior Workers Compensation Claims Adjuster

Job Description

Job Description

Description:

The Builders Group is a self-insured workers’ compensation fund for construction-related companies in MN and we’re currently looking for a dynamic Worker’s Compensation Claims Specialist to join our Claims team. You would be responsible for managing the claim from investigation to resolution. This involves assessing liability/compensability, evaluating losses, and adjusting assigned claims. In addition, the role involves interacting with injured workers, medical providers, self-insured employers, and other third parties throughout the claims management process.

If you also have great people skills, excellent business acumen, are self-driven and have an outstanding work ethic, we would love to hear from you!

KEY RESPONSIBILITIES:

Claims Management

• Manage of caseload including complex or high-exposure workers’ compensation claims through investigation, evaluation, negotiation, and resolution.
• Determine compensability, calculate benefits, and authorize medical and indemnity payments in accordance with state laws and company policy.
• Coordinate treatment plans, return-to-work programs, and settlement strategies with medical providers, attorneys, TBG members, and vendors.
• Maintain detailed documentation in the claims management system and ensure timely reporting and compliance with regulatory requirements.
• Participate in mediations, settlement conferences, and hearings as needed, often in collaboration with outside counsel.
• Collaborate with internal medical, legal, and risk management resources to ensure optimal claim outcomes.
• Identify opportunities for early intervention, cost containment, and fraud prevention.
• Educate members on claims trends, loss drivers, and best practices for injury prevention.
• Collaborate cross-functionally with underwriting, account management, and loss control to deliver coordinated client solutions.

Compliance and Best Practices

• Ensure full compliance with applicable federal, state, and local workers’ compensation laws and regulations. Adhere to internal policies, procedures, and service standards.
• Stay informed on industry changes, case law, medical guidelines, and legislative updates.
• Maintain required adjuster licenses and participate in continuing education and professional development.
• Contribute to the development and refinement of claims handling procedures and client service protocols.
• Promote ethical conduct and high-quality claim management at all times.

Requirements:

QUALIFICATIONS/SKILLS:

• High School diploma or equivalent required, College degree preferred.
• 3+ years of workers’ compensation claims handling experience preferred.
• Must have a Minnesota Adjusters License.
• Experience in client-facing roles such as account management, claims consulting, or relationship management preferred.
• Prior experience mentoring or training others is a strong plus.
• Multi-jurisdictional claims experience desirable.
• Minimum of one (1) to two (2) years Workers’ Compensation lost time claims adjusting experience, or equivalent experience.
• Ability to coordinate and prioritize daily workflow of a moderate technical complexity.
• Must be detail oriented and a self-starter with strong organizational abilities.
• Excellent written and oral communication skills.
• Proficient using Microsoft Office programs such as Word, Excel, Outlook, etc.
• Ability to work with initiative in a mostly independent environment.
• Working knowledge of claim procedures, policies, terminology, etc.
• Working understanding of differences in techniques, medical care available and vocational possibilities within geographic areas of the state.
• Demonstrate problem-solving and analytical ability.
• Spanish bilingual desirable or other languages.
• Ability to travel as necessary.
• Ability to negotiate, build consensus and resolve conflict.
• Ability / willingness to acquire a valid MN State adjusting license.
• Sit, stand, walk/ambulatory; ability to lift 10 pounds.

Working Hours are from 8am-4pm and based on a 37.5 work week. A remote schedule is available after completing training. Required to come into the office once a month for employee meetings.

We close at 2pm on Fridays.

WHAT WE OFFER

TBG offers a competitive wage based on experience and a variety of benefits including health and dental insurance, life insurance, disability, personal time off, paid holidays, vehicle/cell phone/home internet allowance, and a 401(k) plan with Company Match.

WHO WE ARE

In 1997, a group of 56 construction companies got together and decided to do something about the out of control costs of workers’ comp insurance. The plan was simple: join together to create a self-insured workers’ comp fund based on the principle... “If responsible people acted responsibly, everyone wins.”

Today, that idea has grown to become the #1 self-insured workers’ comp fund in Minnesota, exclusive to the construction trades. Through TBG, the construction industry has access to affordable, high-quality workers’ comp tailored specifically to their needs. They have a partner who fully understands their risks and is committed to helping them lower costs, create safer workplaces and take better care of their workers.

If being empowered to help our members along their safety journey sounds like an exciting opportunity, apply to join the TBG team today. To learn more, visit

The Builders Group is an Equal Opportunity Employer.

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance