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Provide clear, professional communication to clients and injured workers—setting expectations early and escalating complex exposures to senior adjusters appropriately. In this role you’ll manage a high-volume portfolio of medical-only claims from first report through closure — ensuring regulatory compliance, accurate reserving, timely medical management, and a professional experience for both employers and injured workers.

YEAR

ProService Hawaii is seeking an Associate Workers’ Compensation Claims Adjuster to join our Claims & Compliance team. In this role you’ll manage a high-volume portfolio of medical-only claims from first report through closure — ensuring regulatory compliance, accurate reserving, timely medical management, and a professional experience for both employers and injured workers.This role sits at the intersection of legal compliance, medical oversight, and client service. What makes it challenging — and rewarding — is that success requires disciplined execution across all three simultaneously, at volume, without missing a deadline.<hr/>IN THIS ROLE YOU WILL<ul><li>Investigate and manage medical-only workers’ compensation claims end-to-end, including three-point contact, compensability determinations, reserving, and action plan execution</li><li>Establish and maintain accurate claim reserves within 48 hours of assignment and ensure timely, accurate medical bill review and payment</li><li>Apply evidence-based treatment guidelines (e.g., ODG) to evaluate medical care, address unsupported treatment, and proactively mitigate risk of claim escalation to indemnity status</li><li>Maintain strict diary management and meet all regulatory deadlines, ensuring audit-ready files and zero missed compliance requirements</li><li>Provide clear, professional communication to clients and injured workers—setting expectations early and escalating complex exposures to senior adjusters appropriately</li><li>Identify red flags such as lost time exposure, attorney involvement, or treatment complexity, and partner with senior adjusters to transition files when appropriate</li></ul><hr/>WHAT YOU'LL BRING TO THE TEAMWe don't measure candidates by résumé alone. We're looking for people who hold themselves to a standard most don't, take feedback as fuel, and are wired to own their results. Prior workers’ compensation experience is required. A valid Hawaii WC Adjuster license in good standing is preferred, and we’ll help support you in obtaining proper licensing. We’re looking for someone who thrives under structure, owns their caseload without being managed to it, and holds themselves to a standard most people don’t.<ul><li>You’ve managed a high-volume WC caseload combined with tight deadlines and diary management.</li><li>You make sound compensability and reserving decisions—and you can explain them clearly</li><li>You know Hawaii WC statutes and can apply them accordingly. You stay current on reporting requirements and flag compliance risks before they become problems.</li><li>You bring calm, composure, and professionalism to difficult conversations; setting expectations clearly and following through.</li></ul><hr/>IS THIS ROLE RIGHT FOR YOU?We want you to walk in with clear eyes, so here's an honest look at what this role is — and what it isn't.This is a high-volume, process-driven, deadline-critical role where precision and documentation are non-negotiable. You’ll be managing 110–130 active medical-only claims at any given time—each with its own statutory timeline, reserve adequacy requirement, and client expectation. The work is structured by design, and performance is tracked closely. You own your caseload, your diary, and your files. We expect adjusters who stay ahead of their files, not behind them.<hr/>WORK LOCATIONWe welcome applications from candidates based in Hawaii, who would work a hybrid schedule (in-office Tuesday–Thursday, option for remote Monday & Friday).<hr/>COMPENSATIONThe base compensation for this position is $60,000.00 – $75,000.00 per year depending on experience and qualifications.<hr/>WHY PROSERVICEProService is a Hawaii-based PEO combining payroll, HR, and benefits expertise with purpose-built technology — all backed by the best local service in Hawaii. Backed by Silver Lake and recognized as one of Hawaii’s Best Places to Work for 20 consecutive years, we’re a team of high performers united by one mission: Empowering Employers to Succeed in Hawaii.<ul><li>A PROhana unlike any other. We assume the best in each other, give feedback focused on what’s right—not who’s right—and show up every day. This isn’t just a workplace. It’s a community.</li><li>Do work that matters. You’ll see exactly how your contributions move the needle—meaningful problems, real decisions, and a seat at the table.</li><li>Grow without a ceiling. Internal roles post first, and we reimburse certifications, conferences, and memberships. Your growth is our growth.</li><li>Compete, collaborate, and win together. High expectations, real accountability, and a team of experts ready to help you push through any obstacle.</li><li>Total rewards built around your whole life. Fully paid healthcare, 401(k) matching, paid parental leave, student loan assistance, employee assistance programs, and paid time off—just to name a few.</li></ul>

ProService Hawaii

Associate Workers' Compensation Claims Adjuster

Attorney

Calendar Management

Claims Processing

Communication Skills

Customer Service Evaluation

File Audits

Healthcare Customer Service

Legal

Licensing

Maintain Compliance

Medical Billing

Patient Care

Performance Analysis

Regulations

Regulatory Compliance

Risk Management

Structured Design

Time Management

Worker's Compensation

clearcompany

You'll be expected to manage a caseload of 90–100 active files, maintain a 1:1 or better new-to-closure ratio, and keep every diary current — all while staying ahead of statutory deadlines and delivering a strong client experience. Actively manage medical treatment plans using evidence-based guidelines (ODG), initiate IMEs when appropriate, and coordinate return-to-work and vocational strategies to reduce indemnity duration.

ProService Hawaii is looking for a Workers' Compensation Claims Adjuster to own the full lifecycle of assigned indemnity claims — from first report through resolution. This is a high-visibility, client-facing role where you're trusted to make sound decisions, manage costs responsibly, and move claims forward with urgency and discipline.What makes this role distinct from a traditional carrier environment is the level of ownership expected. Our adjusters operate in a highly visible, client-facing model every file is yours, and your results are visible.IN THIS ROLE YOU WILL<ul><li>Manage a full caseload of approximately 90–100 active indemnity/lost time claims, driving each toward timely and cost-effective resolution</li><li>Conduct thorough investigations, determine compensability, establish accurate reserves within 48 hours of assignment, and document clear, forward-looking claim strategies</li><li>Actively manage medical treatment plans using evidence-based guidelines (ODG), initiate IMEs when appropriate, and coordinate return-to-work and vocational strategies to reduce indemnity duration</li><li>Ensure strict compliance with Hawaii workers' compensation statutes, regulatory deadlines, and benefit payments — maintaining zero missed deadlines and audit-ready files</li><li>Prepare for and represent employer/carrier at hearings before the Hawaii DLIR, Disability Compensation Division</li><li>Communicate proactively with employers, injured workers, attorneys, and medical providers — setting expectations early, explaining decisions clearly, and managing escalations with composure and authority</li></ul><hr/>WHAT YOU'LL BRING TO THE TEAMWe don't measure candidates by resume alone. We're looking for people who hold themselves to a standard most don't, take feedback as fuel, and are wired to own their results. Proven success managing full-cycle workers' compensation claims, including indemnity and litigated files, is required.<ul><li>You've managed full-cycle indemnity claims and can point to outcomes you drove. You've owned compensability decisions, defended reserve strategies, and guided complex files to resolution — and you can speak to the judgment calls you made along the way.</li><li>You know Hawaii WC statutes and apply them with confidence. Statutory timelines, hearing procedures, compliance requirements — these aren't things you look up every time. You stay current and flag risks before they become problems.</li><li>You analyze medical documentation and push back when the evidence doesn't support the claim. You apply ODG and other treatment guidelines with credibility, challenge unsupported care, and know when an IME is the right move.</li><li>Your files tell the full story. Your documentation doesn't just record what happened — it captures your rationale, your strategy, and your next steps. Audit-ready is your baseline.</li><li>You maintain composure and professionalism under pressure. Difficult claimants, frustrated employers, opposing counsel — you manage those interactions with clarity and professionalism.</li></ul><hr/>IS THIS ROLE RIGHT FOR YOU?We want you to walk in with clear eyes, so here's an honest look at what this role is — and what it isn't.This is a full-cycle indemnity claims role in a metrics-driven environment where performance standards are high and results are tracked closely. You'll be expected to manage a caseload of 90–100 active files, maintain a 1:1 or better new-to-closure ratio, and keep every diary current — all while staying ahead of statutory deadlines and delivering a strong client experience. You'll be given real responsibility and the room to exercise it — setting strategy, making decisions, and moving claims forward on your own terms within a team that supports your success.<hr/>WORK LOCATIONWe welcome applications from candidates based in Hawaii, who would work a hybrid schedule (in-office Tuesday–Thursday, option for remote Monday & Friday).<hr/>COMPENSATIONThe base compensation for this position is $76,000.00 – $98,000.00 per year depending on experience and qualifications.<hr/>WHY PROSERVICEProService is a Hawaii-based PEO combining payroll, HR, and benefits expertise with purpose-built technology — all backed by the best local service in Hawaii. Backed by Silver Lake and recognized as one of Hawaii’s Best Places to Work for 20 consecutive years, we’re a team of high performers united by one mission: Empowering Employers to Succeed in Hawaii.<ul><li>A PROhana unlike any other. We assume the best in each other, give feedback focused on what’s right—not who’s right—and show up every day. This isn’t just a workplace. It’s a community.</li><li>Do work that matters. You’ll see exactly how your contributions move the needle—meaningful problems, real decisions, and a seat at the table.</li><li>Grow without a ceiling. Internal roles post first, and we reimburse certifications, conferences, and memberships. Your growth is our growth.</li><li>Compete, collaborate, and win together. High expectations, real accountability, and a team of experts ready to help you push through any obstacle.</li><li>Total rewards built around your whole life. Fully paid healthcare, 401(k) matching, paid parental leave, student loan assistance, employee assistance programs, and paid time off—just to name a few.</li></ul>

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Associate Workers' Compensation Claims AdjusterProService Hawaii

Workers' Compensation Claims AdjusterProService Hawaii

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