Claims Adjuster

Description ESSENTIAL FUNCTIONS: 1. Handle workersu2019 compensation claims caseload from inception to final settlement involving the following: 2. Original set up of claim. 3. Responsible for performing a factual investigation of claim. 4. Set reserves and determine compensability. 5. Communicating daily with claimants, medical personnel, and representatives from housing authorities for updates. 6. Pay weekly lost time claims and medical bills. 7. Assign rehabilitation referrals and legal representation as needed. 8. Coordinate with nurse case managers, vocational counselors, attorneys, and professional surveillance services to bring claims to a conclusion. 9. Update claims information into Riskmaster Claimu2019s System to include medical notes and daily activity. 10. Transmit medical bills to bill review vendor, scan, and attach medical bills to claim. 11. File all claims documentation into paper file. 12. Preparing of all required IC forms. 13. Subrogation against third parties. 14. Attend IC hearings or mediations, if required. 15. Settle claims within established dollar authority - $50,000 (settlement/reserve authority established by management). All claims above settlement authority are approved by CEO or CFO. 16. Notify reinsurer of claims that fall under reinsurance category. 17. Closure of claim (and all items necessary for closure, i.e., payment, forms, hard copy of file). 18. Transmit Medicare Secondary Payer through ISO Navigator. 19. Provide status of claims at staff meetings and board meetings when requested. 20. Attend educational seminars, safety seminars, and classes as assigned. 21. Perform u201cSpecial Projectu201d work when requested by Management. 22. Assist with the daily operations of the office. Requirements JOB QUALIFICATIONS: EDUCATION High School Diploma, Minimum of two years college Claims experience, 1+ years desired Adjusteru2019s License for the State of North Carolina OTHER REQUIRED SKILLS: Ability to work independently or in a team environment must have excellent verbal and written communication skills, effective organizational skills; accuracy and neatness in work, pitch in when needed on other tasks, ability to work under pressure, and proficient in MS Office (Excel, Work, Outlook, etc.) Robert Half is the worldu2019s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app ( and get 1-tap apply, notifications of AI-matched jobs, and much more. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. u00a9 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking u201cApply Now,u201d youu2019re agreeing to Robert Halfu2019s Terms of Use ( and Privacy Notice (.

Created: 2026-03-19