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Sr. Workers Compensation Adjuster
Albuquerque, New Mexico, United States
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We are on the lookout for an experienced Workers' Compensation Adjuster to join our clients team. You will be responsible for investigating and evaluating losses while developing a plan of action to bring claims to proper resolution in a timely manner.   


This role does require you to live in New Mexico and have New Mexico adjuster license, with a minimum of 5-7 years of experience handling Workers' Compensation claims. 


Key Responsibilities

  • Determines extent of insurance coverage and compensability on each filed claim
  • Investigates claims, including interviewing employees, employers and witnesses
  • Obtains necessary records, including but not limited to, hospital records, police reports, physician records, etc.
  • EDI and CMS/Section 111 reporting
  • Utilizes appropriate preferred vendors
  • Presents thorough and accurate reports to client and/or carrier on claims investigations/situations
  • Negotiates settlements for resolutions with claimants and their attorneys
  • Maintains control of litigation activities and costs per account requirements
  • May be asked to mentor, train and/or share expertise with other Davies staff 
  • Attends meetings; conferences; workshops or training sessions; and reviews written material to maintain current knowledge on principles, practices and new developments in assigned work areas
  • Maintains and meets specific licensing requirements
  • Responds to client questions and comments in a courteous and timely manner
  • Is responsible for catastrophic losses, complex litigation, and other sensitive issues
  • All other duties as assigned


Skills, knowledge & expertise

  • Ability to understand and follow oral and/or written policies, procedures and instructions
  • Ability to perform a wide variety of duties and responsibilities with accuracy and speed, while meeting time-sensitive deadlines 
  • Ability to conduct investigations in multi-party situations 
  • Ability to use standard or customized software applications appropriate to assigned tasks
  • Ability to prepare and present accurate, reliable and factual reports with recommendations 
  • Thorough knowledge of current principles and practices associated with claims investigations, adjustment and related practices 
  • Extensive knowledge of medical and legal terminology with a thorough understanding of Legal principles/litigation management
  • Ability to handle confidential information 
  • Ability to communicate effectively with others both orally and in writing
  • Ability and willingness to learn quickly and utilize new skills because of rapidly changing information and/or technology 
  • Ability to comprehend multi-state laws and regulations to assist other offices, as necessary 


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