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Worker's Compensation Claims Adjuster III
Intercare Holdings Insurance Services. Investigate complex, catastrophic, and high-exposure workers’ compensation claims .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Expertise in managing complex, high-exposure workers' compensation claims, including litigation, settlement negotiations, and multi-party liability. Strong ability to mentor junior adjusters and maintain client relationships while ensuring compliance with Texas WC statutes and regulations.
Highest-signal resume keywords
Workers' Compensation Claims ManagementLitigation Direction and Trial PreparationComplex Case ResolutionClient Relationship ManagementMentoring and Supervisory Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Indemnity ManagementPermanent Disability RatingMulti-Party Lien ResolutionCatastrophic Injury ManagementLife Care Planning CoordinationSettlement NegotiationFraud DetectionReserve EstablishmentSubrogation RecoveryClaims Administration
Soft Skills
Proactive CommunicationStrategic PlanningProblem SolvingTeam LeadershipClient Advocacy
Tools & Technologies
Claims Management PlatformsMicrosoft Office
Certifications & Qualifications
Texas Worker's Comp LicenseAICARMWCCPCPCU
Industry Keywords
Public Entity Liability ClaimsSelf-Insured ProgramsPooled Insurance ArrangementsMulti-Jurisdiction ExperienceTexas WC Statutes
About the role
Key responsibilities & impact- Investigate complex, catastrophic, and high-exposure workers’ compensation claims
- Perform three-point contact on all new losses and maintain detailed action plans with strategic resolution planning
- Identify fraud indicators and refer cases to SIU
- Gather and document facts on claims involving multi-party liability, catastrophic injury, significant subrogation potential, or novel legal issues
- Lead medical management, direct specialists, coordinate life care planners, direct UR and IMEs, and manage PTD cases
- Partner with case managers to maximize early return to work and review high-cost or unusual medical treatment
- Lead permanent disability ratings on complex cases
- Establish and adjust reserves on high-exposure files with documented justification
- Ensure status reports comply with client reporting timelines and formats
- Direct litigation, including selecting defense counsel, setting strategy, retaining experts, managing legal spend, and preparing for trial
- Lead mediations, settlement conferences, and arbitrations
- Make or recommend high-value settlement authority decisions with the Claims Supervisor and client
- Negotiate and finalize high-value settlements, including C&R and Stipulated Awards
- Manage multi-lien resolution and coordinate with lien counsel and CMS
- Pursue subrogation, multi-defendant contribution, and apportionment recovery
- Coordinate with recovery vendors and outside subrogation counsel
- Provide technical backup for the Claims Supervisor and guidance on complex decisions, reserve adequacy, and escalated client issues
- Mentor Adjuster I and II colleagues and support unit-wide quality review
- Serve as a senior contact for key client accounts and maintain client and carrier relationships
- Maintain proactive, transparent communication and respond within required timeframes
Requirements
What you’ll need- Minimum 7 years of WC claims experience including at least 5 years of independent indemnity management with expertise in complex, high-exposure, and litigated files; OR Bachelor’s degree and a minimum of 5 years of WC indemnity experience at an independent level; OR equivalent combination
- Comprehensive knowledge of public entity liability claims including JPAs, self-insured programs, and pooled insurance arrangements
- Active Texas Worker's Comp or all lines license required; multi-state preferred
- Professional designations such as AIC, ARM, WCCP, or CPCU are a plus but not required
- Deep expertise in Texas WC statutes
- Multi-jurisdiction experience highly valued
- Direct experience working within one or more claims administration or claims processing platforms commonly used in worker’s compensation/insurance claims handling
- Demonstrated experience directing complex litigation through mediation, settlement conference, and trial preparation
- Advanced knowledge of PD rating, MSA requirements, and multi-party lien resolution
- Experience with catastrophic injury management and life care planning coordination
- Familiarity with claims management platforms
- Proficiency in Microsoft Office
- Demonstrated ability to mentor junior adjusters and serve as a supervisory backup or senior technical resource
- Strong client relationship management skills
- Experience handling escalated concerns at a senior level
- Must be based in Texas; preference for 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) and company-paid holidays
- Employee assistance resources
- Supportive culture that values balance and wellbeing
- Remote work arrangement