Claims Adjuster

Job Description

Position : WORKERS’ COMPENSATION ADJUSTER

Location : Golden, CO

Work Year: 12 Months

Job Summary

We are seeking an experienced Workers' Compensation Claims Adjuster to manage workers' compensation claims from initial report through resolution. The Claims Adjuster will investigate claims, determine compensability, calculate benefits, coordinate medical and claim-related activities, and maintain accurate claim records.

The ideal candidate will have strong knowledge of workers' compensation claims processes, excellent communication skills, and the ability to manage multiple claims while ensuring timely and consistent claim handling.

Key Responsibilities

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• Gather initial claim information, including employee and incident details.
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• Investigate the circumstances and mechanism of injury and determine claim compensability and coverage.
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• Interview injured employees, supervisors, witnesses, and other relevant parties as needed.
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• Establish and monitor appropriate claim reserves.
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• Maintain claim information, notes, action plans, and status updates within the claims management system.
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• Manage claims efficiently while providing regular updates to employees and internal stakeholders.
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• Review medical treatment and lost-time claims to determine appropriate benefits.
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• Coordinate independent medical examinations and other medical reviews when necessary.
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• Work with employees, managers, HR, payroll, medical providers, and other stakeholders regarding work status and claim-related matters.
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• Calculate average weekly wages and process indemnity payments as applicable.
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• Identify claims that may require additional investigation, surveillance, or special investigation support.
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• Coordinate with defense counsel on claims involving litigation and assist with the resolution process.
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• Evaluate claims for potential settlement and negotiate settlements within assigned authority.
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• Maintain accurate and complete claim documentation and records.
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• Monitor claims to identify opportunities for timely resolution and cost control.
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• Stay current with workers' compensation regulations, company policies, insurance requirements, and industry best practices.
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• Perform other duties as assigned.
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Required Qualifications

Experience

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• Minimum 3 years of experience in workers' compensation claims adjusting .
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• Experience handling claims from initial intake through resolution.
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• Knowledge of workers' compensation claims investigation, benefits, medical treatment, and settlement processes.
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Education

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• High School Diploma or equivalent required.
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• Associate's Degree or additional college coursework preferred.
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