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Workers' compensation claims adjuster skills for your resume and career

Updated January 8, 2025
3 min read
Workers' compensation claims adjuster example skills
Below we've compiled a list of the most critical workers' compensation claims adjuster skills. We ranked the top skills for workerss' compensation claims adjuster based on the percentage of resumes they appeared on. For example, 27.8% of workers' compensation claims adjuster resumes contained customer service as a skill. Continue reading to find out what skills a workers' compensation claims adjuster needs to be successful in the workplace.

15 workers' compensation claims adjuster skills for your resume and career

1. Customer Service

Customer service is the process of offering assistance to all the current and potential customers -- answering questions, fixing problems, and providing excellent service. The main goal of customer service is to build a strong relationship with the customers so that they keep coming back for more business.

Here's how workerss' compensation claims adjuster use customer service:
  • Developed and introduced new customer service policies, which resulted in increased customer retention and improved customer satisfaction within a saturated market
  • Deliver superior customer service and satisfaction through effective interactions with insured, injured workers, agents and legal counsel.

2. Claim Process

Here's how workerss' compensation claims adjuster use claim process:
  • Authorized specialist referrals to expedite claim processing and mitigate long-term financial exposures of clients.
  • Initiated contact and guided injured workers and employers through the entire claim process.

3. Compensation Benefits

Here's how workerss' compensation claims adjuster use compensation benefits:
  • Determine eligibility of insurance coverage, compensation benefits, medical treatment, and medical billing payment.
  • Determine eligibility and if appropriate, pay time loss compensation benefits.

4. Settlement Authority

Here's how workerss' compensation claims adjuster use settlement authority:
  • Negotiate settlements, and present recommendations to clients and insurance carriers for settlement authority.
  • Advised defense attorneys on settlement authority and case management strategies.

5. Data Entry

Data entry means entering data into a company's system with the help of a keyboard. A person responsible for entering data may also be asked to verify the authenticity of the data being entered. A person doing data entry must pay great attention to tiny details.

Here's how workerss' compensation claims adjuster use data entry:
  • Case make-up, including data entry.
  • Perform other routine clerical duties including the use of office equipment, data entry, filing and managing emails.

6. Litigation

Here's how workerss' compensation claims adjuster use litigation:
  • Manage litigation, pay timely compensation, file necessary state forms timely, negotiate appropriate settlements within company assigned authority.
  • Recommended settlement strategies, including litigation management to assist in the expedited resolution of claims.

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7. Workers Compensation Claims

Here's how workerss' compensation claims adjuster use workers compensation claims:
  • Licensed all lines Insurance adjuster specializing in bodily injury and litigated workers compensation claims for 4 state jurisdictions.
  • Exercised independent judgment in investigation, negotiation and settlement of workers compensation claims within authority limits.

8. Medical Bills

Here's how workerss' compensation claims adjuster use medical bills:
  • Authorize appropriate payment of medical bills, temporary and permanent disability benefits within established limits.
  • Evaluated accident reports, ensured the timely processing of medical bills and disability benefits.

9. Claims Management

Here's how workerss' compensation claims adjuster use claims management:
  • Reviewed and filed all correspondence received on claim files handled and maintained current notes and diary using claims management system.
  • Coordinate actions with claimants, medical providers and internal departments to ensure claims management.

10. Medical Treatment

Here's how workerss' compensation claims adjuster use medical treatment:
  • Provided detailed breakdown of future medical treatments including calculation of MSA allocation amount and future medical cost projections.
  • Coordinated and processed external referrals for medical treatments with medical facilities for the claimants/patients medical conditions or illness.

11. Medical Claims

Here's how workerss' compensation claims adjuster use medical claims:
  • Reviewed medical claims, providing documentation and communication with attorneys and physicians.
  • Investigated auto accident related medical claims for appropriate benefits and coverage.

12. Rehabilitation

Here's how workerss' compensation claims adjuster use rehabilitation:
  • Skilled in management of Private Rehabilitation Counselors commissioned to provide services to injured workers.
  • Coordinate all provided medical and vocational rehabilitation services to the catastrophically injured worker.

13. Claims Handling

Here's how workerss' compensation claims adjuster use claims handling:
  • Managed all aspects and levels of claims handling in multiple jurisdictions with a primary focus on NY post 9/11 claims.
  • Review new and current case law and statutory changes to ensure accurate and appropriate claims handling recommendations.

14. Medical Management

Medical management helps navigate all facets of health care to improve the quality and outcomes of health care delivery for health, disease, nursing, and case management functions. The goal of medical management is to improve the delivery of all medications, improve patient use, reduce side effects and interactions of drugs, and provide peace of mind to patients as they can be confident that medications are being taken correctly.

Here's how workerss' compensation claims adjuster use medical management:
  • Coordinated medical management and directed legal counsel to assist in facilitating a successful resolution to each claim.
  • Assigned medical management and vocational specialists when needed.

15. State Regulations

State regulations are the rules made by the state authorities under a specific Act. When a government intervenes in the private market to implements policies, they are known as state regulations. These policies help in achieving the economic, political, and social targets which might not be able to achieve otherwise.

Here's how workerss' compensation claims adjuster use state regulations:
  • Complied with state regulations as well as company policies and procedures as they related to workers compensation matters.
  • Initiate letters, state reporting forms and all necessary documents per state regulations.
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List of workers' compensation claims adjuster skills to add to your resume

The most important skills for a workers' compensation claims adjuster resume and required skills for a workers' compensation claims adjuster to have include:

  • Customer Service
  • Claim Process
  • Compensation Benefits
  • Settlement Authority
  • Data Entry
  • Litigation
  • Workers Compensation Claims
  • Medical Bills
  • Claims Management
  • Medical Treatment
  • Medical Claims
  • Rehabilitation
  • Claims Handling
  • Medical Management
  • State Regulations
  • Compensation Laws
  • State Forms
  • Medical Care
  • Strong Negotiation
  • Medical Benefits
  • TPA
  • State Laws
  • Defense Counsel
  • Permanent Disability
  • Vocational Rehabilitation
  • Indemnity Payments
  • Authority Limits
  • Juris
  • Medical Reports
  • Injury Claims
  • Policy Coverage
  • EDI
  • Open Claims
  • Compensation Commission
  • Medical Professionals
  • Settlement Negotiations
  • Status Reports
  • Insurance Coverage
  • Medical Appointments
  • Defense Attorneys
  • Benefit Payments
  • Medical Documentation
  • CPT
  • Arbitration
  • Indemnity Benefits
  • Compensation ACT

Updated January 8, 2025

Zippia Research Team
Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

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