Senior Workers Compensation Claims Adjuster

Gallagher Bassett seeks a Senior Claims Adjuster, Workers Compensation, to manage complex lost-time claims from intake through resolution. You will investigate coverage and compensability, collect medical and wage documentation, evaluate liability and reserves, and determine appropriate benefits in compliance with state workers compensation statutes. The role includes negotiating settlements, coordinating return-to-work and medical management strategies, and collaborating with clients, injured workers, providers, and attorneys. You will prepare reports, attend hearings or mediations as needed, and support continuous improvement in claims outcomes within a professional, client-focused team.

Responsibilities

• Manage complex workers compensation claims from first notice of loss through closure

• Investigate coverage, compensability, and liability using statements, records, and documentation

• Analyze medical reports, wage data, and legal requirements to determine appropriate benefits

• Set and adjust case reserves in line with company guidelines and best practices

• Coordinate with medical providers, nurse case managers, and employers on treatment and return-to-work plans

• Negotiate settlements and prepare settlement recommendations for clients and management

• Ensure full compliance with state workers compensation statutes and internal policies

• Prepare clear, timely claim notes, status reports, and client communications

• Participate in mediations, hearings, or depositions as required

• Contribute to process improvements and mentor junior adjusters as needed Required Skills

• Workers compensation claims handling

• Claims investigation

• Medical and wage documentation analysis

• Reserve setting and evaluation

• Settlement negotiation

• Knowledge of state workers compensation statutes

• Claims litigation coordination

• Return-to-work and disability management

• Claims management systems (e.g., RMIS)

• Written and verbal communication