We are partnered with a TPA who has immediate needs for Remote Senior Workers Compensation Claims adjusters in Oregon. These are temporary positions with the possibility of temp to hire. Must reside in the state of Oregon.

The candidate must have a valid license for their state of domicile if that state requires a license. Valid licenses in additional jurisdictions preferred. Candidate must be willing to learn other jurisdictions, handle multiple programs/clients. Candidates will be handling claims in multiple states.

• Must have 3 to 5 years of overall claims experience handling Workers Compensation claims.
• Must be eligible for reserve/payment authority level of $50,000+ when appropriate
• Must possess required Adjuster’s license(s) with the ability to obtain other required jurisdictional licensing.

The candidate will handle a caseload of approximately 150 pending claims encompassing all levels of complexity. Requires establishing facts of loss, coverage analysis, investigation, compensability/liability/negligence determination, coordination of medical care, litigation management, damage assessment, settlement negotiations, identifying potential fraud & appropriate use of authorized vendors. Includes timely & appropriate reserve analysis & report completion.

• Essential Duties and Responsibilities:
• Investigation:
  • Verify facts of loss and pertinent claims facts such as employment, wages, or damages and establish disability with treating physicians as appropriate.
  • Identify cases for settlement. Evaluate claims and request authority no later than 30 days before the mediation date and negotiate a settlement.
  • Evaluate and negotiate liens.
  • Recognize and report potential fraud cases.
• Litigation Management:
  • Develop and direct a litigation plan with defense attorney (if assigned), utilizing all defenses and tools to bring the file to closure. Ensure all filings and state-mandated forms are promptly completed. Litigated files must be diaried effectively based on current activity, but no greater than every 60 days.
  • Review claim files involving active litigation every month at minimum, and document responses to filings, development of defenses, depositions, and timely referral to defense counsel.
  • Direct the actions of defense counsel on litigated files.
  • Attend mediations and trials as required for cost-effective litigation management.

We are partnered with a TPA who has immediate needs for Remote Senior Workers Compensation Claims adjusters in New York and Oregon. These are temporary positions with the possibility of temp to hire. Must live in the state of New York and/or Oregon.

The candidate must have a valid license for their state of domicile if that state requires a license. Valid licenses in additional jurisdictions preferred. Candidate must be willing to learn other jurisdictions, handle multiple programs/clients. Candidates will be handling claims in multiple states.

• Must have 3 to 5 years of overall claims experience handling Workers Compensation claims.
• Must be eligible for reserve/payment authority level of $50,000+ when appropriate
• Must possess required Adjuster’s license(s) with the ability to obtain other required jurisdictional licensing.

The candidate will handle a caseload of approximately 150 pending claims encompassing all levels of complexity. Requires establishing facts of loss, coverage analysis, investigation, compensability/liability/negligence determination, coordination of medical care, litigation management, damage assessment, settlement negotiations, identifying potential fraud & appropriate use of authorized vendors. Includes timely & appropriate reserve analysis & report completion.

• Essential Duties and Responsibilities:
• Investigation:
  • Verify facts of loss and pertinent claims facts such as employment, wages, or damages and establish disability with treating physicians as appropriate.
  • Identify cases for settlement. Evaluate claims and request authority no later than 30 days before the mediation date and negotiate a settlement.
  • Evaluate and negotiate liens.
  • Recognize and report potential fraud cases.

• Litigation Management:
  • Develop and direct a litigation plan with defense attorney (if assigned), utilizing all defenses and tools to bring the file to closure. Ensure all filings and state-mandated forms are promptly completed. Litigated files must be diaried effectively based on current activity, but no greater than every 60 days.
  • Review claim files involving active litigation every month at minimum, and document responses to filings, development of defenses, depositions, and timely referral to defense counsel.
  • Direct the actions of defense counsel on litigated files.
  • Attend mediations and trials as required for cost-effective litigation management.