Workers' Compensation Complex Claims Adjuster
Berkshire Hathaway GUARD Insurance Companies
full-time
Posted on:
Location Type: Hybrid
Location: New York City • New Jersey • New York • United States
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Salary
💰 $50,000 - $100,000 per year
About the role
- Manage a caseload of complex, lost‑time and litigated NY claims from start to finish, ensuring accuracy, timeliness, and strategic decision‑making
- Handle complex NY loss‑time workers’ compensation claims, including litigated matters and high‑exposure files
- Determine compensability and coverage for claims under New York Workers’ Compensation Law and other applicable jurisdictions
- Drive settlement strategy, including negotiation and finalization of agreements under management review
- Gather, evaluate, and interpret medical and factual evidence to support defensible claim outcomes
- Coordinate and lead outside investigations, including IMEs, surveillance, and specialized field work
- Manage and direct outside counsel, ensuring litigation progresses efficiently and within authority
- Communicate frequently with injured workers, attorneys, investigators, medical providers, insureds, agents, and internal partners
- Execute timely and accurate claims handling, including documentation, reserving, payment processing, and compliance reporting
Requirements
- 5+ years of New York loss‑time workers’ compensation experience, including litigated claims (required)
- Experience handling NY Employer’s Liability claims (strong plus)
- Ability to manage claims across multiple jurisdictions, with willingness to learn additional states
- Strong negotiation, conflict resolution, and problem‑solving skills
- Excellent organization and time‑management, with the ability to handle a fast‑moving caseload
- Effective written and verbal communication skills, including file documentation and attorney interactions
- A positive, solutions‑oriented approach and the ability to contribute to a high‑performing team
- Bachelor’s degree preferred; equivalent experience considered
- Active NY Adjuster License a strong plus
Benefits
- Competitive compensation
- Healthcare benefits package that begins on first day of employment
- 401K retirement plan with company match
- Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
- Up to 6 weeks of parental and bonding leave
- Hybrid work schedule (3 days in the office, 2 days from home)
- Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
- Tuition reimbursement after 6 months of employment
- Numerous opportunities for continued training and career advancement
- And much more!
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
New York Workers’ Compensation Lawlitigated claimsclaims handlingsettlement strategynegotiationmedical evidence evaluationclaims documentationpayment processingcompliance reportingEmployer’s Liability claims
Soft Skills
negotiationconflict resolutionproblem-solvingorganizationtime managementwritten communicationverbal communicationsolutions-orientedteam collaborationstrategic decision-making
Certifications
NY Adjuster License