Worker's Compensation Claims Adjuster II

Intercare Holdings Insurance Services

. Independently manage a complex inventory of indemnity claims from intake through resolution .

Posted 10/2/2026full-timeRemote • Texas • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing Texas Worker's Compensation indemnity claims from intake to resolution, including directing medical care and negotiating settlements. Proficient in analyzing case facts, assessing compensability, and maintaining compliance with applicable statutes and guidelines.

Highest-signal resume keywords

Texas Worker's Compensation Claims AdjustingIndemnity Claims ManagementActive Texas Worker's Comp LicenseClaims Management PlatformsMedical Record Interpretation

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AdjustingCase Fact AnalysisCompensability AssessmentSettlement NegotiationLitigation Strategy ManagementSubrogation PursuitPermanent Disability RatingCase Reserve ManagementMedical Control DirectionThree-Point Contact

Soft Skills

Proactive CommunicationIndependent ManagementDecision MakingNegotiation SkillsCollaboration with Case Managers

Tools & Technologies

Microsoft OfficeClaims Management Platforms

Certifications & Qualifications

Texas Worker's Comp LicenseAICARMWCCP

Industry Keywords

Texas WC StatutesIndemnity ClaimsFraud IndicatorsLitigated ClaimsReturn-to-Work Programs

About the role

Key responsibilities & impact

Independently manage a complex inventory of indemnity claims from intake through resolution
Perform three-point contact within 24 hours on all new losses
Gather and analyze case facts, assess compensability, and maintain current plans of action
Identify and refer fraud indicators to the SIU
Handle claims in accordance with applicable statutes, service contracts, and company guidelines
Direct medical care throughout the claim lifecycle, including treatment authorization, medical control, UR and IME direction, and VR plan review
Partner with case managers to maximize early return-to-work
Identify and rate permanent disability in accordance with applicable state guidelines
Establish, monitor, and adjust case reserves within assigned authority levels
Prepare accurate and strategically clear 90-day carrier status reports
Direct defense counsel, set litigation strategy, manage legal budgets, and drive litigated files toward efficient resolution
Attend mediations and settlement conferences and make settlement authority decisions
Negotiate and finalize claim settlements, including lien resolution
Pursue subrogation, multi-defendant contributions, and apportionment on pre-existing disability cases
Respond to inquiries within required timeframes
Maintain proactive communication with injured workers, employers, carriers, counsel, and vendors

Requirements

What you’ll need

Minimum of 3 years of Texas Worker's Compensation claims adjusting experience with a Bachelor's degree
5 years of Texas Worker's Compensation claims adjusting experience without a Bachelor's degree
Demonstrated ability to independently manage indemnity claims through resolution
Active Texas Worker's Comp or all lines license required
Multi-state license preferred
Professional designations such as AIC, ARM, or WCCP a plus
Working knowledge of Texas WC statutes
Experience directing defense counsel and managing litigated claims
Familiarity with claims management platforms
Proficiency in Microsoft Office
Ability to read and interpret medical records and IME reports
Candidates must be based in Texas, with preference for the Austin area

Benefits

Comp & perks

Comprehensive medical, dental, and vision benefits
Company contributions to HSA and FSA plans
Employer-paid life and disability insurance
401(k) with company match
Paid time off (PTO)
Company-paid holidays
Employee assistance resources
Supportive culture that values balance and wellbeing