Associate Workers' Compensation Claims Adjuster
ProService Hawaii is the largest local HR partner in Hawaii, delivering HR solutions to businesses and employees across the islands. As an Associate Workers’ Compensation Claims Adjuster, you will manage a portfolio of medical-only claims, ensuring compliance and effective communication while controlling claim costs.
Responsibilities
- Investigate and manage medical-only workers’ compensation claims end-to-end, including three-point contact, compensability determinations, reserving, and action plan execution
- Establish and maintain accurate claim reserves, ensure timely medical bill review and payment, and document all activity in compliance with Hawaii statutory requirements
- Apply treatment guidelines to evaluate medical care, address unsupported treatment, and proactively mitigate risk of claim escalation
- Maintain strict diary management and meet all regulatory deadlines, ensuring audit-ready files and zero missed compliance requirements
- Provide clear, professional communication to clients and injured workers, setting expectations early and escalating complex exposures appropriately
Skills
- Experience handling workers' compensation claims, preferably medical-only or other low-complexity files
- Working knowledge of Hawaii workers' compensation statutes and reporting requirements
- Ability to interpret medical records and apply evidence-based treatment guidelines
- Proven ability to manage 100+ active claims while meeting strict deadlines and performance targets
- Clear, structured written documentation and professional verbal communication skills
- Strong judgment in reserving and compensability decisions within established authority levels
Benefits
- Full benefits
- Resources to support your well-being
Company Overview