Workers’ Compensation Medical Only Claims Adjuster (Remote)

Our StoryImagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.What's in StoreAt Davies North America, we’re focused on delivering smart, efficient claims solutions that make a real impact for our clients. We’re seeking a Workers’ Compensation Medical Only Claims Adjuster who brings strong technical expertise, sound judgment, and a proactive approach to managing indemnity and medical-only claims.This role manages Workers’ Compensation claims from intake through resolution and may support medical-only, claim types depending on the assigned client program. The adjuster investigates, evaluates, and manages claims in accordance with company guidelines, client expectations, and jurisdictional requirements.Key ResponsibilitiesClaim Ownership & AdjudicationManage Workers’ Compensation claims from intake through closureDetermine compensability and benefit eligibilityEstablish and adjust reserves based on claim exposureInvestigation & Case ManagementConduct investigations, including interviews and documentation reviewDevelop and execute claim strategiesIdentify opportunities for early resolutionMedical & Indemnity ManagementMonitor treatment plans and coordinate return-to-work effortsAdminister indemnity benefits in compliance with jurisdictional requirementsLitigation ManagementCoordinate with defense counsel on litigated claimsSupport hearings, mediations, and settlementsClient Communication & ComplianceProvide timely updates to clients and stakeholdersEnsure compliance with all state regulations and internal standardsSkills, knowledge & expertiseStrong knowledge of Workers’ Compensation laws, benefit structures, and claims processesExperience managing indemnity payments and return-to-work programsAbility to handle multiple claims in a fast-paced environmentStrong investigative, analytical, and decision-making skillsEffective negotiation and problem-solving abilitiesExcellent written and verbal communication skillsProficiency with claims management systems and related technologyActive adjuster license(s) or ability to obtain as requiredActive FL license neededPreferredMulti-state claims handling experienceExperience with EDI reporting and jurisdictional compliance requirementsFamiliarity with nurse case management and medical cost containment strategies Equal Employment Opportunity & Legal NoticesBenefitsAt Davies North America, we are dedicated to supporting the well‑being and future of our qualifying employees. Our comprehensive benefits package includes:Medical, dental, and vision plans to support your health and that of your familyA 401(k) plan with employer matchingTime‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employeesPaid holidaysLife insurance and short‑term and long‑term disability coverageBenefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee’s primary work location.Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.Diversity and InclusionDavies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.Compensation Transparency: The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices. Essential Functions The following responsibilities and expectations are considered essential to the successful performance of this role. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform these essential functions.Maintain regular and dependable attendance.Be available and able to perform job responsibilities during established work hours.Background Check & Fair Chance Compliance Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair‑chance hiring requirements.Massachusetts NoticeIt is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.AI PolicyAt Davies, we value authentic conversations and a fair candidate experience. While candidates may use AI and technology tools to prepare for interviews, we expect interview responses and assessments to reflect each individual's own experience, knowledge, and professional judgment. We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at recruitment@davies-group.com