Workers' Compensation Complex Claims Adjuster (NY)

Overview

Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett’s Berkshire Hathaway group – one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.

Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company’s success is grounded in our core values:  accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!

Benefits:

We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You’ll be surprised by all we have to offer!

• Competitive compensation
• Healthcare benefits package that begins on first day of employment
• 401K retirement plan with company match
• Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
• Up to 6 weeks of parental and bonding leave
• Hybrid work schedule (3 days in the office, 2 days from home)
• Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
• Tuition reimbursement after 6 months of employment
• Numerous opportunities for continued training and career advancement
• And much more!

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:

• 5+ 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.

This role may be based out of any of our office locations, including:

New York, NY; Parsippany, NJ; Philadelphia, PA; Conshohocken, PA; Wilkes‑Barre, PA; Alpharetta, GA; Rosemont, IL; Plano, TX; Scottsdale, AZ; and Rancho Cordova, CA.

The salary ranges below reflect broad pay bands based on cost‑of‑labor groupings. Actual base pay will vary depending on factors such as experience, education, skills, performance, job responsibilities, and work location.

High‑Cost Markets

(e.g., New York City, Northern New Jersey, parts of California, Chicago)

Estimated Base Salary Range: $60,000 – $100,000

Standard‑Cost Markets

(e.g., Pennsylvania, Texas, Georgia, Arizona, Illinois, remaining markets)

Estimated Base Salary Range: $50,000 – $90,000