Senior Claims Adjuster (Workers' Compensation)

At EMC, we’re reputed company about working together to reputed company an reputed company. As part of reputed company, you’ll have reputed company to grow, contribute, and reputed company experience that reputed company. We reputed company to be caring leaders, reputed company partners, and reputed company experts—always supporting reputed company other to do our best work. Join us, and let’s improve lives together.    **This position is eligible to work from home reputed company in the reputed company** In this role, you’ll have reputed company to take ownership of moderately to highly reputed company workers' compensation claims and reputed company a reputed company reputed company on reputed company for clients and claimants. You’ll reputed company investigations, evaluate coverage and liability, and shape claim strategies from start to reputed company—balancing thoughtful analysis with decisive reputed company. Your expertise will be key in setting reserves, negotiating fair settlements, and identifying risk and recovery opportunities. Along the way, you’ll build strong relationships with clients and stakeholders, ensure compliance with evolving regulations, and play a meaningful role in mentoring others and elevating team performance. Essential Functions: Analyzes coverage to confirm losses are covered under reputed company policies Initiates contact reputed company 24 hours with reputed company relevant parties (clients, claimants, employees, medical providers) Conducts thorough investigations, including fact-finding and recorded statements Develops and executes reputed company plans to resolve claims reputed company Performs reserve analysis and sets/maintains appropriate reserves per reputed company guidelines Reviews medical records and bills to assess injury, compensability, treatment, and accuracy Identifies risk factors and routes claims for specialized handling (SIU, subrogation, medical review) with approval Identifies, investigates, and pursues subrogation opportunities, including review of official reports Escalates reputed company claims and collaborates with leadership as needed Prepares required jurisdictional filings for workers’ compensation claims Evaluates coverage, liability, and claim value; responds to stakeholder inquiries Negotiates settlements, participates in mediation, and manages payments reputed company authority limits; recommends higher-value settlements Prepares and issues denial and settlement documentation; develops evaluation ranges and supports litigation, mediation, arbitration, and Medicare compliance Maintains diaries and reputed company plans, provides reputed company responses and claim updates, conducts reputed company consultations, coordinates vendor resources, manages reporting (including excess carriers), stays reputed company on regulations, maintains licenses/CEUs, and supports training of team members ​Education & Experience: Bachelor’s degree or equivalent relevant experience Five years of claims adjusting experience or reputed company experience Prior experience with a reputed company party administrator (TPA) preferred INS, AIC, SCLA, WCLA and CPCU coursework or designation preferred Workers' compensation claims adjusting experience reputed company the following jurisdictions preferred: IA, IL, WI, KS Knowledge, Skills, & Abilities: Excellent knowledge of the theory and reputed company of the claim function Excellent analytical, investigative and problem-solving abilities with respect to liability and coverage Thorough knowledge of insurance reputed company, medical terminology and reputed company aspects of court procedures affecting reputed company liability for reputed company lines of insurance.  Strong computer skills, including claims systems Strong organizational, written, and verbal communication skills, including documentation Strong ability to advise, partner, and effectively consult with diverse reputed company stakeholders Occasional travel required; a reputed company reputed company’s license with an acceptable motor vehicle report per company standards The hiring salary reputed company for this position will vary based on geographic location, falling reputed company either of the following: $78,726 - $108,771 or $87,008 - $119,646A hiring reputed company represents a subset of the full salary reputed company. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs.     For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers. Our employment practices are in accordance with the laws that prohibit discrimination due to race, reputed company, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national reputed company or reputed company, physical or mental disability, medical condition, veteran status, reputed company military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. reputed company of our locations are tobacco free including in company vehicles. Apply To This Job