Senior Workers’ Compensation Adjuster

JOB SUMMARY:

This position is responsible for a variety of professional duties in handling workers’ compensation claims in Georgia for Georgia Power, along with handling claims in Georgia for Southern Company Services, Southern Power, and Southern Communications, and providing backup workers’ compensation claim support for Southern Nuclear Company in both Georgia and Alabama. This role is responsible for investigating, analyzing, and managing claims, including determining compensability, handling indemnity, medical, financial exposure and payments, state form filings, Medicare reporting, working with defense counsel on legal/litigation issues, subrogation actions, excess/re-insurer reporting, Subsequent Injury Trust Fund (SITF) reporting, and other miscellaneous tasks. This role requires timely and thorough communication with a variety of stakeholders. This role requires a strong compliance component to follow federal laws and guidance, state laws and rules, and company processes and policies in handling claims.

Please Note: This is a hybrid position with in-office presence expectation at 241 Ralph McGill Blvd, Atlanta, GA. 

JOB REQUIREMENTS: 

Education:

• High School Diploma Required

• Associate Degree or Bachelor's Degree Desired

Work Experience:

• Minimum 5 years claims related experience in handling complex workers’ compensation claims required
• Ideal candidate will have claims experience in Georgia and Alabama
• Knowledge of accepted industry standards and practices

Preferred:

• Experience as a lost-time adjuster for a Third-Party Administrator or Self-Insured Company for 5+ years

MAJOR JOB RESPONSIBILITIES: 

 Functional Expertise:                                                                                                

• Partners with employees, leadership, Medical & Health Services, Safety, medical providers, vendors, and legal counsel to effectively manage and resolve claims

• Determines compensability and manages claims in accordance with Alabama and Georgia Workers’ Compensation laws, rules, and company policies

• Collaborates with external defense counsel to investigate claims and evaluate compensability based on case-specific facts and circumstances

• Serves as a cross-trained resource supporting Southern Nuclear Workers’ Compensation claims across Georgia and Alabama jurisdictions to ensure continuity and consistency

• Applies professional judgment to manage a broad range of complex claim types, including medical-only, lost-time, catastrophic, death, controverted, and litigated claims

• Calculates, analyzes, and manages claim financials, including historical spend and future reserve estimates

• Ensures timely and accurate processing of payments, including indemnity, medical, legal, and related expenses

• Identifies and proactively pursues claim resolution opportunities, including return-to-work strategies, settlements, and appropriate benefit discontinuation

• Evaluates claims for cost containment opportunities while ensuring appropriate and quality medical care

• Coordinates reimbursement and recovery efforts, including excess insurance, Subsequent Injury Trust Fund, and subrogation opportunities

• Communicates with Payroll to ensure proper handling of indemnity offsets and salary-in-lieu payments

• Maintains accurate and detailed claim documentation, including notes, action plans, and supporting information within claim systems