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Workers Compensation Claims Adjuster Jobs in Puerto Rico

JLL

Professional, Facilities Management

Anasco, PR

Coordinates worker's compensation claims process and maintains communication with injured employees, claims administrators, and medical providers * Tracks post-incident follow-up including return-to ...

Acosta

Lead Event Specialist Part Time

Mayaguez, PR · On-site

$13.50/hr

Responsibilities With Regard to Workers' Compensation Claims: You are responsible for reporting all employment related injuries you incur to your direct supervisor as soon as possible following an ...

TOTE Group

Safety and Compliance Specialist

San Juan, PR · On-site

$60 - $80/hr

Investigates and adjusts a wide range of claims, primarily cargo, trucker's auto liability, equipment, workers' compensation, auto liability, and general liability claims. * Assist with the Business ...

New

Deloitte

Epic Denials Management Operator

San Juan, PR · Remote

$17.75 - $23.50/hr

Experience working in claims clearinghouse systems * Familiarity with Epic Analytics and Reporting ... making compensation decisions including but not limited to skill sets; experience and training ...

Mentor Technical Group

EHS Specialist

Cidra, PR · On-site

$80 - $100/hr

... claims, performance metric reports, etc. * Take necessary steps to ensure a safe work environment ... the Worker's Compensation program. * Promote excellent relationship with MENTOR clients ...

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Workers Compensation Claims Adjuster information

What does a workers compensation claims adjuster do?

As a workers' compensation claims adjuster, you analyze workers’ compensation claims, review documentation, and authorize payments. When employees are injured on the job or become ill due to working conditions, they can submit a workers’ comp claim for compensation to cover medical bills and lost time or pay for missed work. Your job duties are to examine the documentation, determine whether compensation is appropriate, and if so, the compensation amount. A claims examiner reviews your claims to ensure that all parties follow proper guidelines and workers’ comp laws.

What does a workers compensation claims adjuster do?

A Workers Compensation Claims Adjuster is responsible for investigating and managing claims filed by employees who are injured or become ill as a result of their job. They review medical reports, interview claimants and employers, and determine the validity of each claim. Adjusters ensure that claims are processed according to state laws and company policies, and they coordinate benefits and settlements. Their goal is to provide fair compensation to employees while preventing fraudulent claims and controlling costs for employers.

What are the key skills and qualifications needed to thrive as a workers compensation claims adjuster?

To thrive as a Workers Compensation Claims Adjuster, you need a solid understanding of insurance principles, claims investigation, and relevant state laws, often supported by a bachelor's degree or industry certifications. Familiarity with claims management software, legal databases, and medical terminology is typically required. Strong analytical thinking, negotiation skills, and empathy are crucial soft skills for effectively managing cases and communicating with claimants and employers. These skills ensure accurate claim resolution, regulatory compliance, and a fair and supportive experience for all parties involved.

What are the main challenges workers compensation claims adjusters face in managing their caseloads?

Workers Compensation Claims Adjusters often handle a high volume of cases, which requires excellent organizational skills and the ability to prioritize effectively. They must balance timely investigation and resolution of claims while ensuring compliance with state regulations and company policies. Navigating sensitive communications with injured employees, medical providers, and legal representatives can also be challenging, especially when disputes arise. Staying current with changing laws and maintaining detailed documentation are essential for success in this role.

What is the difference between Workers Compensation Claims Adjuster vs Insurance Claims Examiner?

AspectWorkers Compensation Claims AdjusterInsurance Claims Examiner
CredentialsState-specific licensing, certifications like CPCU or AIC often preferredAdjuster licenses, certifications like CPCU or AIC often required
Work EnvironmentAdjusts workers' compensation claims, often in offices or on-site at workplacesReviews and processes insurance claims, typically in office settings
Employer & IndustryEmployers include insurance companies, government agencies, and third-party administratorsPrimarily insurance companies and third-party claims organizations

Both roles involve evaluating insurance claims, but Workers Compensation Claims Adjusters focus specifically on workers' compensation cases, often involving workplace injuries, while Insurance Claims Examiners handle a broader range of insurance claims across various policies. The skills, certifications, and work environments are similar, making them closely related but distinct roles within the insurance industry.

More about Workers Compensation Claims Adjuster jobs

What are popular job titles related to Workers Compensation Claims Adjuster jobs in Puerto Rico?

For Workers Compensation Claims Adjuster jobs in Puerto Rico, the most frequently searched job titles are:

What job categories do people searching Workers Compensation Claims Adjuster jobs in Puerto Rico look for?

The top searched job categories for Workers Compensation Claims Adjuster jobs in Puerto Rico are:

Workers Compensation Claims Adjuster jobs near you
Infographic showing various Workers Compensation Claims Adjuster job openings in Puerto Rico as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, and 4% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution.

HR Business Partner - Spanish/English Bilingual

MY WIRELESS

San Juan, PR • On-site

Full-time

PTO

Re-posted 28 days ago

My Wireless rating

2.5

Company rating: 2.5 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

HR Business Partner & Onboarding

HR Business Partner & Onboarder plays a key role in fostering a positive, compliant, and productive work environment. This position is responsible for managing and resolving complex employee issues, ensuring consistent application of company policies, and supporting both employees and leadership in navigating workplace concerns. The role also supports onboarding execution, system setup, and cross-functional HR processes in a multi-state environment.

Primary Duties & Responsibilities

Employee Relations & Policy Management

  • Demonstrate complete knowledge, understanding, and compliance with company policies and procedures
  • Receive, assess, and resolve employee and management questions regarding policies, benefits, and personnel matters
  • Provide coaching, interpretation, and guidance on corrective and progressive actions to ensure consistent policy application
  • Develop strong partnerships with employees and managers to support HR-related decision-making
  • Work closely with operations leadership on employee relations matters

Investigations & Compliance

  • Lead and conduct employee investigations related to workplace conduct, employee relations, retaliation, discrimination, and alleged policy violations
  • Track, document, and provide feedback on employee grievances in accordance with company policy and legal requirements
  • Ensure HR operations comply with all local, state, and federal employment laws and regulations
  • Identify trends, risks, and behavioral patterns using data and case insights to recommend solutions

Leaves, Claims & Agency Coordination

  • Manage and support processes related to:
    • Workers’ compensation claims
    • Unemployment claims and inquiries
    • Leaves of absence (FMLA, state paid leave, disability, and company leaves)
  • Coordinate with third-party administrators, payroll, and leadership to ensure timely and compliant responses
Onboarding & System Support Responsibilities

Onboarding Coordination & Facilitation

  • Conduct and support new hire onboarding sessions, including employee orientation and HR policy overviews
  • Serve as an HR point of contact during onboarding to address questions and ensure a positive new hire experience
  • Ensure onboarding tasks are completed accurately and within required timelines
  • Experience with HRIS systems is a plus.
  • Knowledge of garnishment  and unemployment regulations 
  • Excellent attention to detail and strong organizational skills.
  • Ability to handle sensitive information with confidentiality.
  • Strong communication skills, both written and verbal.
  • Proficient in Microsoft Office Suite (Excel, Word, PowerPoint).

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