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Senior Workers Comp Adjuster-Large Loss Claims Specialist

Senior Workers Comp Adjuster-Large Loss Claims Specialist

CorVelStaten Island, NY, US
1 day ago
Job type
  • Full-time
Job description

Senior Workers' Comp Adjuster-Large Loss Claims Specialist

The Large Loss Workers' Compensation Adjuster is responsible for managing a caseload of complex and high-exposure workers' compensation claims from initial assignment to resolution. This role requires strong technical expertise in claims handling, thorough knowledge of workers' compensation laws and regulations, and the ability to develop strategies that achieve cost-effective and fair claim outcomes. The adjuster will work closely with injured employees, employers, medical providers, attorneys, and internal stakeholders to ensure timely and accurate claim resolution.

This is a remote role.

Essential Functions & Responsibilities :

  • Claim Management

Handle a caseload of large loss and catastrophic workers' compensation claims, including complex medical and indemnity exposures

  • Investigate claims thoroughly to determine compensability, cause, extent of injuries, and potential for subrogation or fraud.
  • Establish and maintain accurate reserves based on file exposure and claim progression.
  • Develop, document, and execute claims strategies tailored to each file.
  • Communication & Coordination
  • Serve as the primary point of contact for all parties involved in the claim, including injured workers, employers, medical providers, attorneys, and internal teams.

  • Provide regular status updates to stakeholders, ensuring transparency and alignment with claim objectives.
  • Collaborate with internal resources such as nurse case managers, vocational experts, and legal counsel to drive claim resolution.
  • Compliance & Documentation
  • Ensure claims are managed in accordance with applicable workers' compensation laws, jurisdictional requirements, and internal guidelines.

  • Maintain complete, organized, and timely claim documentation within the claims management system.
  • Prepare required carrier reports, correspondence, and settlement recommendations.
  • Litigation Management
  • Direct and oversee litigation strategy on contested claims, including selection and oversight of defense counsel.

  • Attend mediations, hearings, and settlement conferences as needed.
  • Financial & Strategic Impact
  • Identify opportunities to control claim costs through proactive management and early intervention.

  • Monitor and manage large loss exposures to protect company assets.
  • Participate in file reviews and provide insight into loss trends, reserving practices, and improvement opportunities.
  • Knowledge & Skills :

  • In-depth knowledge of workers' compensation laws, medical terminology, and claims best practices.
  • Exceptional negotiation, communication, and interpersonal skills.
  • Strong analytical, decision-making, and problem-solving abilities.
  • Ability to manage multiple priorities in a fast-paced environment.
  • Proficiency with claims management systems and Microsoft Office Suite.
  • Education / Experience :

  • Education : Bachelor's degree preferred; equivalent work experience considered.
  • Experience :
  • Minimum 57 years of workers' compensation claims handling experience, with at least 3 years handling large loss / catastrophic claims.

  • Multi-jurisdictional experience strongly preferred.
  • Pay Range :

    CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors : federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

    For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

    Pay Range : $59,681 $96,123

    A list of our benefit offerings can be found on our CorVel website.

    CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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