ProService Hawaii is the largest local HR partner in Hawaii, delivering HR solutions to businesses and employees across the islands. As an Associate Workers’ Compensation Claims Adjuster, you will manage a portfolio of medical-only claims, ensuring compliance and effective communication while controlling claim costs.
Responsibilities
- Investigate and manage medical-only workers’ compensation claims end-to-end, including three-point contact, compensability determinations, reserving, and action plan execution
- Establish and maintain accurate claim reserves, ensure timely medical bill review and payment, and document all activity in compliance with Hawaii statutory requirements
- Apply treatment guidelines to evaluate medical care, address unsupported treatment, and proactively mitigate risk of claim escalation
- Maintain strict diary management and meet all regulatory deadlines, ensuring audit-ready files and zero missed compliance requirements
- Provide clear, professional communication to clients and injured workers, setting expectations early and escalating complex exposures appropriately
Skills
- Experience handling workers' compensation claims, preferably medical-only or other low-complexity files
- Working knowledge of Hawaii workers' compensation statutes and reporting requirements
- Ability to interpret medical records and apply evidence-based treatment guidelines
- Proven ability to manage 100+ active claims while meeting strict deadlines and performance targets
- Clear, structured written documentation and professional verbal communication skills
- Strong judgment in reserving and compensability decisions within established authority levels
Benefits
- Full benefits
- Resources to support your well-being
Company Overview
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