Associate Workers' Compensation Claims Adjuster

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.ResponsibilitiesInvestigate and manage medical-only workers’ compensation claims end-to-end, including three-point contact, compensability determinations, reserving, and action plan executionEstablish and maintain accurate claim reserves, ensure timely medical bill review and payment, and document all activity in compliance with Hawaii statutory requirementsApply treatment guidelines to evaluate medical care, address unsupported treatment, and proactively mitigate risk of claim escalationMaintain strict diary management and meet all regulatory deadlines, ensuring audit-ready files and zero missed compliance requirementsProvide clear, professional communication to clients and injured workers, setting expectations early and escalating complex exposures appropriatelySkillsExperience handling workers' compensation claims, preferably medical-only or other low-complexity filesWorking knowledge of Hawaii workers' compensation statutes and reporting requirementsAbility to interpret medical records and apply evidence-based treatment guidelinesProven ability to manage 100+ active claims while meeting strict deadlines and performance targetsClear, structured written documentation and professional verbal communication skillsStrong judgment in reserving and compensability decisions within established authority levelsBenefitsFull benefitsResources to support your well-beingCompany OverviewProService Hawaii provides bundled HR solutions that make it easier for employers to succeed. It was founded in 1997, and is headquartered in Honolulu, Hawaii, USA, with a workforce of 201-500 employees. Its website is https://www.proservice.com.



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