Workers' Compensation Claims Adjuster

Gallagher Bassett seeks a Workers Compensation Claims Adjuster to manage a caseload of workers' compensation claims from first notice through resolution. You will investigate injuries, gather medical and wage documentation, determine coverage and compensability, set and adjust reserves, and negotiate settlements within authority. You will collaborate with employers, medical providers, attorneys, and injured workers to drive timely, cost effective outcomes. Using established best practices, you'll analyze claim data, prepare reports, ensure regulatory compliance, and support return to work plans while delivering professional, client focused service.

Responsibilities

• Manage a caseload of workers' compensation claims from first notice to closure

• Investigate claims, gather statements, and review medical and wage documentation

• Determine coverage, compensability, and appropriate benefits per policy and statute

• Set, monitor, and adjust claim reserves based on exposure and file development

• Negotiate claim resolutions and settlements within authority levels

• Coordinate with employers, medical providers, attorneys, and injured workers

• Ensure compliance with jurisdictional regulations and company best practices

• Document claim activity and maintain accurate, timely claim files

• Prepare claim summaries, status reports, and recommendations for clients

• Support return to work strategies and cost containment initiatives Required Skills

• Workers' compensation claims handling

• Claims investigation and interviewing

• Medical record review and analysis

• Coverage and compensability evaluation

• Reserve setting and financial analysis

• Negotiation and settlement skills

• Knowledge of workers' compensation laws and regulations

• Claims management systems (e.g., Guidewire or similar)

• Written and verbal communication

• Report writing and documentation