Claims Adjuster

Job Description

Insight Global is looking for a Senior Claims Examiner to manage a highly active workers' compensation claims desk consisting of approximately 150 claims. This individual will oversee claims from inception through resolution, including future medical claims, delayed claims requiring timely decisions, monthly salary continuation benefit payments, temporary disability benefit payments, and the issuance of timely benefit notices.

This role involves extensive communication with school district employees, client stakeholders, medical providers, attorneys, and other parties throughout the life of each claim. The Senior Claims Examiner will be responsible for driving claims toward efficient and appropriate resolution while maintaining compliance with all timelines, documentation requirements, and reporting obligations.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to View email address on click.appcast.io learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy:

Skills and Requirements

Experience managing a high-volume workers' compensation claims caseload (approximately 150 active claims).

Ability to manage claims from first report of injury through closure.

Conduct timely 3-point contacts with injured employees, employers, and medical providers.

Establish and maintain appropriate claim reserves.

Process benefit payments accurately and on time.

Issue required benefit notices in compliance with regulations.

Manage litigation-related matters and coordinate with defense counsel as needed.

Maintain detailed diaries and action plans to move claims toward resolution.

Make timely coverage and compensability decisions, particularly on delayed claims.

Complete quarterly file reviews and large-loss/excess reporting.

Strong verbal and written communication skills.

Ability to work effectively with clients, medical providers, attorneys, and claimants.

Available to work core business hours of either:

7:00 AM to 4:00 PM

8:00 AM to 5:00 PM Experience supporting public entities, municipalities, or school districts.

Experience handling future medical exposure claims.

Background managing litigated workers' compensation claims.

Experience handling delayed or complex compensability investigations.

Large-loss reporting experience.