Workers’ Compensation Claims Adjuster

MDD Forensic Accountants

Workers’ Compensation Claims Adjuster managing Florida claims. Investigating, evaluating, and ensuring compliance with Florida statutes while delivering exceptional service.

Posted 5/21/2026full-timeRemote • Alabama • 🇺🇸 United StatesMid-LevelSenior💰 $65,000 - $70,000 per yearWebsite

About the role

Key responsibilities & impact

Investigate and evaluate Florida workers’ compensation claims to determine compensability, exposure, and total claim value in accordance with Florida statutes and case law.
Establish and maintain appropriate reserves using reserving tools, ODG guidelines, and company reserving philosophy.
Initiate and manage indemnity payments and maintain diary systems for ongoing payments and claim activity.
Complete state-required filings and EDI reporting accurately and within required timelines.
Assign and coordinate with defense counsel on litigated claims and assist with litigation strategy.
Collaborate with Nurse Case Managers to monitor medical treatment and authorize appropriate medical services under Florida Statute 440.13.
Review and approve medical bills within required timeframes.
Determine need for vocational rehabilitation services to assist injured employees with return-to-work planning.
Coordinate light duty opportunities and workplace accommodations with employers and medical providers.
Maintain consistent communication with clients and attend client meetings as required.
Maintain accurate documentation, diaries, and workflow management to ensure regulatory compliance.
Identify potential subrogation or recovery opportunities and pursue appropriate reimbursement from responsible parties.
Protect Medicare’s interests and ensure compliance with MMSEA Section 111 reporting requirements.
Monitor claims for red flags or potential fraud indicators.
Request reimbursement from excess carriers as required and follow up on outstanding recoveries.
Escalate client concerns or E&O risks to leadership when appropriate.
Maintain performance expectations, including a 97% claim closure ratio.

Requirements

What you’ll need

Workers’ compensation claims handling experience, including lost time and litigated claims
Active Florida All-Lines Adjuster License or Florida Workers’ Compensation License
Experience evaluating claims, setting reserves, and managing litigation files
Strong knowledge of Florida Workers’ Compensation statutes and rules
Experience coordinating with defense counsel and nurse case managers
Proficiency with Microsoft Office Suite
Excellent written and verbal communication skills
Strong organization, prioritization, and time-management skills in a fast-paced environment
Ability to work independently while collaborating with a team
Experience handling multiple claim types or presumption claims
Experience with depositions, mediations, and settlement negotiations
Familiarity with systems such as IDatix, Workers Computation, ISO, or ShoreTel

Benefits

Comp & perks

Medical, dental, and vision plans to ensure your health and that of your family.
A 401k plan with employer matching to help you build a secure financial future.
Our time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
Paid holidays.
Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

workers' compensation claims handlingevaluating claimssetting reservesmanaging litigation filescoordinating with defense counselcoordinating with nurse case managershandling multiple claim typesdepositionsmediationssettlement negotiations

Soft Skills

written communicationverbal communicationorganizationprioritizationtime-managementindependent workteam collaboration

Certifications

Florida All-Lines Adjuster LicenseFlorida Workers’ Compensation License