Job Description

Job Type Full-time Description Worker's Compensation Adjuster Midwest Family Mutual Insurance Company is seeking a skilled and experienced Worker's Compensation Claims Adjuster. This is a telework (work-from-home) position, ideal for a motivated professional who can operate independently with minimal supervision. Applicants must have a minimum 3 years of experience handling Workers' Compensation lost time claims, including litigation. A dedicated home office space and high-speed internet access are required. Midwest Family currently writes Workers' Compensation in the following states: AZ, CO, IA, ID, IL, IN, KS, MN, MO, MT, NE, NM, OR, SD, UT, and WI, with recent expansions into KY, MI, and PA. Experience handling claims across multiple jurisdictions is highly preferred. Experience in South Dakota (SD), Arizona (AZ), and Colorado (CO) is a plus. Essential Job Functions The Workers' Compensation Claims Adjuster is responsible for managing claims efficiently while ensuring fair and equitable outcomes and regulatory compliance. Investigate and Evaluate Claims Confirm coverage and gather relevant facts through interviews and documentation review. Assess eligibility and injury severity to determine compensation according to statute. Review and analyze medical records to support claim decisions. 2. Manage Claims Process Establish and adjust loss reserves appropriately. Negotiate fair and equitable settlements with claimants and their representatives. Maintain clear, accurate documentation of all activities and communications. Monitor vendors and attorneys for performance and cost-effectiveness. 3. Coordinate Medical Care Approve necessary treatments and collaborate with medical providers. Support timely return-to-work initiatives when possible. 4. Legal and Regulatory Compliance Maintain compliance with state Workers' Compensation laws and internal procedures. Prepare and submit required regulatory state filings and internal processes and procedures. Handle disputes and participate in mediation or hearings as needed to reach fair and equitable resolutions. 5. Financial Oversight Monitor claim costs and ensure timely payment of medical bills and benefits. Pursue subrogation and liens when appropriate. 6. Communication and Service Respond promptly and professionally to all inquiries from stakeholders. Provide ongoing support to injured workers throughout the claims process. 7. Continuous Improvement Maintain compliance through continued training on laws, regulations, and best practices. Identify and implement process improvements to enhance claim outcomes. Requirements Ability to work as part of a team. Regular and reliable attendance. Perform other duties as may be assigned. Bachelor's degree preferred. Minimum 3 years of experience handling Workers' Compensation lost time claims. Dedicated home office space and high-speed internet access. Strong knowledge of Workers' Compensation coverage, legal and medical terminology, and relevant laws. Proven ability to negotiate timely, fair, and equitable settlements. Proficient in Microsoft Office with solid keyboarding skills. Excellent written and verbal communication skills. Midwest Family Mutual offers a competitive salary and robust benefits package, including 401(K), and a Pension Plan. Midwest Family Mutual Insurance Company

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