Lost Time Claims Adjuster

Direct message the job poster from Find Great People | FGP

A large client of ours is looking to hire a remote (Workers' Comp) Lost Time Claims Adjuster to join their team. This role is responsible for handling self-administered workers’ compensation and casualty claims across multiple states. The position manages the full lifecycle of each claim—from investigation and assessment to negotiation, resolution, or denial. This person serves as the main contact for associates, legal partners, medical providers, vendors, and internal business units.

This is a remote position but the candidate must reside in the Eastern US, ideally SC, NC, or VA where their operations are.

• Manage a designated caseload of workers’ compensation claims within established performance benchmarks and financial authority.
• Conduct thorough investigations to determine coverage, compensability, and liability while ensuring adherence to all legal and regulatory requirements.
• Track and complete all required statutory filings and deadlines in a timely manner.
• Evaluate claim details to develop strategies that drive favorable outcomes and reduce overall risk and costs to the organization.
• Identify potential fraud indicators and pursue subrogation opportunities when applicable.
• Oversee medical treatment plans, facilitate return‑to‑work efforts, and manage prescription authorizations in coordination with pharmacy benefit managers.
• Apply knowledge of employment laws—including FMLA and ADA—when coordinating claim activities.
• Partner with Safety teams to identify workplace risks and support initiatives that reduce future injuries.
• Build strong working relationships with internal stakeholders (HR, Legal, Operations, Brand teams) and external partners (attorneys, healthcare providers, vendors).
• Oversee a claims portfolio and serve as the primary contact for resolving claim-related questions or issues from associates, vendors, and brand partners.
• Research and address legal or procedural concerns related to ongoing claims and provide timely communication through phone, email, and digital platforms.

• Active adjuster license (state‑specific where required).
• Minimum of four years of lost time claims experience.
• Strong understanding of workers’ compensation laws, regulations, and claims procedures.
• Familiarity with medical terminology used in complex or long‑term claims.
• Proven negotiation and communication skills.

$35/hour

Associate

Full‑time

Human Resources

Retail

Referrals increase your chances of interviewing at Find Great People | FGP by 2x