Workers' Compensation Complex Claims Adjuster (NY)

				Overview:

Good Things Start Here.

Good things are happening at Berkshire Hathaway GUARD Insurance Companies-an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway. With supportive leadership, collaborative teams, and opportunities to grow, GUARD is a place where people build meaningful, long‑term careers.

Good Things You Can Count On.

* Hybrid schedule: 2 days remote / 3 in‑office
* Predictable hours (no nights, weekends, or holidays)
* Competitive pay + generous PTO
* Medical, dental & vision starting day one
* 401(k), tuition reimbursement & longevity bonuses

Responsibilities:

In this role, you'll manage a caseload of complex, lost‑time and litigated NY claims from start to finish, ensuring accuracy, timeliness, and strategic decision‑making. You will:

* Handle complex NY loss‑time workers' compensation claims, including litigated matters and high‑exposure files.
* Determine compensability and coverage for claims under New York Workers' Compensation Law and other applicable jurisdictions.
* Drive settlement strategy, including negotiation and finalization of agreements under management review.
* Gather, evaluate, and interpret medical and factual evidence to support defensible claim outcomes.
* Coordinate and lead outside investigations, including IMEs, surveillance, and specialized field work.
* Manage and direct outside counsel, ensuring litigation progresses efficiently and within authority.
* Communicate frequently with injured workers, attorneys, investigators, medical providers, insureds, agents, and internal partners.
* Execute timely and accurate claims handling, including documentation, reserving, payment processing, and compliance reporting.

Qualifications:

We're looking for a seasoned professional who understands the nuances, pace, and legal demands of New York Workers' Compensation claims. The ideal candidate has:

* 3+ years of New York loss‑time workers' compensation experience, including litigated claims (required).
* Experience handling NY Employer's Liability claims (strong plus).
* Ability to manage claims across multiple jurisdictions, with willingness to learn additional states.
* Strong negotiation, conflict resolution, and problem‑solving skills.
* Excellent organization and time‑management, with the ability to handle a fast‑moving caseload.
* Effective written and verbal communication skills, including file documentation and attorney interactions.
* A positive, solutions‑oriented approach and the ability to contribute to a high‑performing team.
* Bachelor's degree preferred; equivalent experience considered.
* Active NY Adjuster License a strong plus.
			

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