{"schemaVersion":"jobsearcher.job.v1","id":"3da238d629c6ca8d74b9fdc0","url":"https://jobsearcher.com/jobs/3da238d629c6ca8d74b9fdc0","canonicalUrl":"https://jobsearcher.com/jobs/3da238d629c6ca8d74b9fdc0","title":"Claims Adjuster","description":"*Job Description:*\n\nAs a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.\n\n*Responsibilities:*\n\n* Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature\n* Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable)\n* Alert Supervisor and Special Investigations Unit to potentially suspect claims\n* Ensure timely denial or payment of benefits in accordance with jurisdictional requirements\n* Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure\n* Negotiate claims settlements with client approval\n* Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition\n* Work collaboratively with nurse professionals to develop and execute return to work strategies\n* Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome\n* Maintain a working knowledge of jurisdictional requirements and applicable case law for each state serviced\n* Demonstrate technical proficiency through timely, consistent execution of best claim practices\n* Communicate effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues\n* Provide a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions\n* Authorize treatment based on the practiced protocols established by statute or the Managed Care department\n* Assist clients by suggesting panel provider information in accordance with applicable state statutes.\n* Demonstrate commitment to Company’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.\n\nPay: $31.00 - $41.00 per hour\n\nExpected hours: 40.0 per week\n\nBenefits:\n* 401(k)\n* Dental insurance\n* Health insurance\n* Paid time off\n* Vision insurance\n\nWork Location: Hybrid remote in Ithaca, NY 14853","company":"FirstPro","rawCompany":"firstpro","city":"Ithaca","state":"NY","isRemote":false,"isActive":false,"createdAt":"2026-09-11T11:25:36.174Z","occupations":[{"code":"13-1031.00","title":"Claims Adjusters, Examiners, and Investigators","slug":"claims-adjusters-examiners-and-investigators"},{"code":"43-9041.00","title":"Insurance Claims and Policy Processing Clerks","slug":"insurance-claims-and-policy-processing-clerks"},{"code":"13-2053.00","title":"Insurance Underwriters","slug":"insurance-underwriters"}],"industries":[{"code":"524291","title":"Claims Adjusting","slug":"claims-adjusting"},{"code":"524298","title":"All Other Insurance Related Activities","slug":"all-other-insurance-related-activities"},{"code":"524292","title":"Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds","slug":"pharmacy-benefit-management-and-other-third-party-administration-of-insurance-and-pension-funds"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Claims Adjuster","description":"*Job Description:*\n\nAs a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.\n\n*Responsibilities:*\n\n* Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature\n* Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable)\n* Alert Supervisor and Special Investigations Unit to potentially suspect claims\n* Ensure timely denial or payment of benefits in accordance with jurisdictional requirements\n* Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure\n* Negotiate claims settlements with client approval\n* Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition\n* Work collaboratively with nurse professionals to develop and execute return to work strategies\n* Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome\n* Maintain a working knowledge of jurisdictional requirements and applicable case law for each state serviced\n* Demonstrate technical proficiency through timely, consistent execution of best claim practices\n* Communicate effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues\n* Provide a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions\n* Authorize treatment based on the practiced protocols established by statute or the Managed Care department\n* Assist clients by suggesting panel provider information in accordance with applicable state statutes.\n* Demonstrate commitment to Company’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.\n\nPay: $31.00 - $41.00 per hour\n\nExpected hours: 40.0 per week\n\nBenefits:\n* 401(k)\n* Dental insurance\n* Health insurance\n* Paid time off\n* Vision insurance\n\nWork Location: Hybrid remote in Ithaca, NY 14853","datePosted":"2026-09-11T11:25:36.174Z","dateModified":"2026-09-11T11:25:36.174Z","hiringOrganization":{"@type":"Organization","name":"FirstPro","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Ithaca","addressRegion":"NY","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"3da238d629c6ca8d74b9fdc0"},"url":"https://jobsearcher.com/jobs/3da238d629c6ca8d74b9fdc0"}}