Randstad Digital Americas · 2 hours ago
Sr Workers Compensation Claims Adjuster
Farmington, MI
Full-time
Onsite
Senior Level
$23/hr - $33/hrRandstad Digital Americas is seeking a Senior Workers' Compensation Adjuster responsible for managing complex Workers' Compensation claims. The role involves independent planning, investigation, and ensuring compliance with guidelines to mitigate financial exposure on complicated claims.
Information Technology & Services
Responsibilities
Handle the day-to-day management of all Workers' Compensation claims, including complex cases, claims from the date of injury, controverted claims, and pension claims, in accordance with established claim guidelines and state regulations
Investigate losses and determine or deny coverage and compensability through contact with the claimant, insured, and other involved parties
Establish and maintain appropriate case reserves for each claim based on case specifics and company guidelines to accurately reflect the financial exposure
Manage files in litigation and coordinate with defense counsel. Negotiate claims for settlement within assigned authority levels
Review and make appropriate decisions regarding medical bills, wage claims, temporary and permanent disability, and death benefits
Refer files to appropriate parties for medical management or special investigative needs, and monitor the status of work performed. Consult with and monitor service providers such as legal counsel, medical, and vocational professionals
Ensure compliance with procedural guidelines for all reports (diary, EDI, excess, review reports). Stay apprised of current law changes and court rulings affecting claim handling
Identify potential subrogation opportunities and refer them to the appropriate external or internal parties
Qualification
Required
High school diploma is necessary
Extensive professional experience in claims handling
Independent Adjuster's license for Florida is necessary
Strong analytical skills
Excellent verbal and written communication skills
Effective problem-solving skills
Attention to detail
Proficient computer skills, including Microsoft Office Suite
Demonstrated successful ability to build positive relationships and partnerships with policyholders, agents, and internal stakeholders
Preferred
Associate's or bachelor's degree
Knowledge of Guidewire Claim Center
Professional certifications such as AIC or SCLA
Benefits
Medical
Prescription
Dental
Vision
AD&D
Life insurance offerings
Short-term disability
401K plan
Company
Randstad Digital Americas
Randstad Digital is a trusted digital enablement partner that facilitates accelerated transformation for businesses by providing global talent, capacity, and solutions across specialized domains.
Founded in 1984
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Graig Paglieri
CEO, Randstad Digital Americas
Pascal de Hesselle
SVP, Executive Client Partner - Technology, Media & Telecom
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