Job Description

As a Senior Workers’ Compensation Claims Adjuster at Rural Mutual Insurance Company, you will manage complex lost-time and litigated workers’ compensation claims, including catastrophic cases and those reported to reinsurance. This position requires technical expertise and leadership skills to ensure compliance, accuracy, and exceptional customer service. You will play a critical role in resolving claims efficiently while collaborating across departments to improve processes and outcomes. This position will primarily work remotely with occasional travel to support team and business needs within the state of Wisconsin. If you are ready to join a supportive team of customer-focused professionals and use your expertise to make a real difference, this is the opportunity for you. Responsibilities: • Investigate claims by obtaining statements, medical authorizations, and records; coordinate independent medical exams, nurse case management, and surveillance as needed. • Evaluate compensability, determine medical relatedness, and decide on claim acceptance or denial in compliance with state statutes. • Manage litigation, negotiate settlements, and maintain accurate case reserves within assigned authority. • Collaborate with loss control and underwriting teams to identify safety and operational issues within insured businesses. • Identify subrogation opportunities and coordinate recovery efforts with internal resources. • Ensure compliance with company policies, procedures, and regulatory requirements. • Prepare and maintain accurate documentation for claims and reinsurance reporting; participate in process improvement initiatives and special projects. Qualifications: • Bachelor’s degree in business, insurance, or related field preferred; or equivalent experience. • Minimum of 3 years of workers’ compensation claims adjusting experience, including complex and litigated cases. • Strong knowledge of state workers’ compensation laws and regulations. • Supervisory or team leadership experience strongly preferred. • Proficiency in Microsoft Office Suite and insurance-related software. • Excellent analytical, investigative, and negotiation skills. • Ability to work independently and manage multiple priorities in a remote environment. • Strong written and verbal communication skills for clear stakeholder interaction. • Commitment to integrity, accountability, and delivering superior customer service. • Ability to travel occasionally for client visits and meetings. About Company: What You'll Love About Rural Mutual Insurance: We are a leading property and casualty insurance company based in Wisconsin, well known for our financial strength and longevity in the insurance industry. Our reputation in the marketplace ensures stability and opens up numerous growth opportunities for our employees.  We created a welcoming place to work with friendly and professional leadership. We are known for the great care we take with our staff, our agents, and our customers. We are passionate and determined about delivering the best customer service, preserving insurance industry knowledge, and making a difference through the work that we do. We believe in a healthy work/life balance and, to that end, offer a competitive and comprehensive compensation package including health, dental, life, LTD, and vision insurance as well as an employee bonus plan, matching 401(k) plan, and generous time off benefits.

Job Tags

Work at office, Remote work,

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