Workers' Compensation Lost Time Adjuster (Remote)

Davies
United States
Workplace: RemoteFull timeUSD 70,000 - 75,000 annuallyFunction: People, HR & TalentExperience: 3+ yearsSkills: ["Investigation","Analysis","Decision-making","Negotiation","Communication","Time management","Handling sensitive information"]

Investigate, evaluate, and manage Workers’ Compensation lost time claims across the full lifecycle—from initial investigation through resolution. Determine compensability and coverage, conduct interviews and evidence gathering, and analyze medical, legal, and employment documentation. Ensure EDI reporting and CMS Section 111 compliance, develop claim action plans for complex/litigated files, and negotiate settlements to control costs and deliver clear reporting to clients and excess carriers.

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Davies
Davies
1 day ago

Workers' Compensation Lost Time Adjuster (Remote)

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Source: Company careers pageValidated by: Fursa AI
Last checked: 6 hours agoStatus: Live

Job Summary

Investigate, evaluate, and manage Workers’ Compensation lost time claims across the full lifecycle—from initial investigation through resolution. Determine compensability and coverage, conduct interviews and evidence gathering, and analyze medical, legal, and employment documentation. Ensure EDI reporting and CMS Section 111 compliance, develop claim action plans for complex/litigated files, and negotiate settlements to control costs and deliver clear reporting to clients and excess carriers.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: People, HR & Talent
Seniority: Mid level

Key Responsibilities

  • •Own the full lifecycle of Workers’ Compensation claims from initial investigation through resolution.
  • •Determine compensability and coverage with accuracy.
  • •Conduct detailed investigations, including interviews and evidence gathering.
  • •Analyze medical, legal, and employment documentation to guide decision-making.
  • •Develop claim plans for complex or litigated matters, partner with defense counsel, and negotiate settlements.

Pay and Benefits

Salary: USD 70,000 - 75,000 annually
Perks:Health InsuranceDentalVision401kPaid LeavePaid HolidaysLife InsuranceDisability

Key Requirements

  • •3+ years of Workers’ Compensation claims handling experience.
  • •Experience with lost time claims, compensability analysis, and claim strategy.
  • •Active adjuster licenses as required by jurisdiction (or ability to obtain).
  • •Knowledge of Workers’ Compensation laws and jurisdictional requirements.
  • •Strong investigation, analysis, and decision-making skills with effective negotiation and communication.
Experience:3+ yearsWorkers' compensationClaims handlingInsuranceLost time claimsLitigated claims
Skills:InvestigationAnalysisDecision-makingNegotiationCommunicationTime managementHandling sensitive information
Licenses:Adjuster license
Tech Stack:EDICMS Section 111Claims systems

Company Brief

Davies
Davies is a specialist professional services and technology firm delivering claims, underwriting, and risk solutions to insurers, reinsurers, brokers and regulated businesses globally, with major capabilities in claims management, forensics, and digital transformation.
Industry: Consulting
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Established Company
Valuation: Unicorn (USD 1B+)
Funding: Private Equity Backed
Headquarters: City of London, United Kingdom
Founded: 1968
Glassdoor
Glassdoor: 3.8
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