New Mexico Workers' Compensation Adjuster (Remote in NM)

Department: Claims Administration & Adjusting

Employment Type: Permanent - Full Time

Location: Remote, NM

Reporting To: Kimberly Jordan Binkley

Compensation: $85,000 - $92,000 / year

Description

What's in Store
We are on the lookout for an experienced Workers' Compensation Adjuster to join our team. You will be responsible for investigating and evaluating losses while developing a plan of action to bring claims to proper resolution in a timely manner.
This role does require you to live in New Mexico and have New Mexico adjuster license, with a minimum of 5-7 years of experience handling Workers' Compensation claims.

Key Responsibilities

• Determines extent of insurance coverage and compensability on each filed claim
• Investigates claims, including interviewing employees, employers and witnesses
• Obtains necessary records, including but not limited to, hospital records, police reports, physician records, etc.
• EDI and CMS/Section 111 reporting
• Utilizes appropriate preferred vendors
• Presents thorough and accurate reports to client and/or carrier on claims investigations/situations
• Negotiates settlements for resolutions with claimants and their attorneys
• Maintains control of litigation activities and costs per account requirements
• May be asked to mentor, train and/or share expertise with other Davies staff
• Attends meetings; conferences; workshops or training sessions; and reviews written material to maintain current knowledge on principles, practices and new developments in assigned work areas
• Maintains and meets specific licensing requirements
• Responds to client questions and comments in a courteous and timely manner
• Is responsible for catastrophic losses, complex litigation, and other sensitive issues
• All other duties as assigned

Skills, knowledge & expertise

• Ability to understand and follow oral and/or written policies, procedures and instructions
• Ability to perform a wide variety of duties and responsibilities with accuracy and speed, while meeting time-sensitive deadlines
• Ability to conduct investigations in multi-party situations
• Ability to use standard or customized software applications appropriate to assigned tasks
• Ability to prepare and present accurate, reliable and factual reports with recommendations
• Thorough knowledge of current principles and practices associated with claims investigations, adjustment and related practices
• Extensive knowledge of medical and legal terminology with a thorough understanding of Legal principles/litigation management
• Ability to handle confidential information
• Ability to communicate effectively with others both orally and in writing
• Ability and willingness to learn quickly and utilize new skills because of rapidly changing information and/or technology
• Ability to comprehend multi-state laws and regulations to assist other offices, as necessary

Benefits

At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and vision plans to support your health and that of your family
• A 401(k) plan with employer matching
• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees
• Paid holidays
• Life insurance and short-term and long-term disability coverage

Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee's primary work location.

Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.

Essential Functions
The following responsibilities and expectations are considered essential to the successful performance of this role. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform these essential functions.

• Maintain regular and dependable attendance.
• Be available and able to perform job responsibilities during established work hours.