Worker's Compensation Claims Adjuster II

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🤠 Texas – Remote

🤠 Texas – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 11%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Intercare Holdings Insurance Services

WebsiteLinkedInAll Job Openings

201 - 500 employees

🛡️ Insurance

Insurance • Risk Management

Intercare Holdings Insurance Services is a privately held company that specializes in workers' compensation and liability claims administration, managed care services, and risk management solutions. Known for their client care and responsive service, Intercare integrates advanced technology and has an in-house Special Investigations Unit (SIU) to handle claims efficiently and reduce fraudulent activities. Their unique approach combines the depth and capacity of a large organization with the flexibility of a smaller firm, ensuring customized risk management and cost control solutions for clients. With a strong emphasis on customer satisfaction, Intercare is a trusted partner in reducing risk and maintaining fiscal stability for their clients.

📋 Description

• 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

• 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

• 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