Job Description

Midwest Family Mutual Insurance Company is seeking a skilled and experienced Workers 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 of 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.

1. Investigate and evaluate claims, including confirming coverage, gathering relevant facts through interviews and documentation review, assessing eligibility and injury severity, and reviewing medical records to support claim decisions.
2. Manage claims process by establishing and adjusting loss reserves, negotiating settlements, maintaining documentation, and monitoring vendors and attorneys.
3. Coordinate medical care by approving treatments and supporting return-to-work initiatives.
4. Ensure legal and regulatory compliance by adhering to laws, preparing filings, and handling disputes.
5. Oversee financial aspects by monitoring claim costs, ensuring timely payments, and pursuing subrogation when appropriate.
6. Maintain communication by responding to inquiries and supporting injured workers throughout the process.
7. Engage in continuous improvement through training and process enhancements.

Requirements

• Ability to work as part of a team and maintain reliable attendance.
• Minimum 3 years of experience handling Workers' Compensation lost time claims.
• Dedicated home office space and high-speed internet.
• Strong knowledge of Workers' Compensation coverage, laws, and medical terminology.
• Proven negotiation skills for settlements.
• Proficiency in Microsoft Office and good keyboarding skills.
• Excellent communication skills.

Midwest Family Mutual offers a competitive salary and benefits, including 401(K) and Pension Plan.

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