Worker's Compensation Claims Adjuster III

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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

• 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

• 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

• 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