Workers’ Compensation Senior Claims Adjuster - California

About Us

At Davies, we get it... you are not just looking for a job, you are looking to build a life and a career. We believe in our people and realize that our success is a direct result of creating a learning atmosphere, leadership opportunities, and promoting from within.

We believe that engaging in corporate social activities and working together as a team is a vital part of the Davies culture.

With a multinational global team, Davies Group is a specialist professional services and technology firm working in partnership with leading insurance, highly regulated, and global businesses.

At Davies Group, we help clients to manage risk, operate core business processes, and to transform and grow. We deliver operations, consulting and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation, customer experience, human capital, transformation, and change management.

Are you looking for a company that is Dynamic and Innovative where the teammates are Connected and Succeed Together? If so, Davies may just be the right choice for you.

Job Overview

American Claims Management, a part of Davies Specialty Programs, is looking for a Senior Workers’ Compensation Claims Adjuster to manage a caseload of workers’ compensation indemnity cases from inception to resolution.

Maintain communication with clients, producers and employers via telephone and written correspondence, attending occasional claims review meetings with customers.

Reporting to the Claims Manager, you will be responsible for managing a diary system to ensure timely benefit administration and superior claims management.

Opportunity to work from home.

Responsibilities and Duties :

• Conduct and direct investigation to determine AOE / COE, includes 24-hour 3-point contact to employee, employer & MD.
• Establish initial reserves timely and maintain accurate reserves based on probable outcome on all claims.
• Authorize appropriate medical care, issue timely indemnity benefits and manage all legal aspects of all claims.
• Provide quality customer service to clients, producers, employers and injured workers.
• Determine settlement value and resolution while moving all cases towards appropriate closure.
• Perform other duties as needed.

Experience and Qualifications

• WCCA Preferred
• WCCP Preferred
• California Self-Insured License Preferred

Knowledge, Skills and Abilities

• Excellent communication skills both written and oral with a strong focus towards exceptional customer service.
• Ability to investigate, summarize and present claim facts to vendors, clients and management.
• Work independently and maintain a positive work atmosphere in an environment of rapidly changing priorities.
• Self-starter who can work under minimum direction to meet or exceed goals and objectives.
• Excellent organizational, problem solving and decision-making skills required.

Diversity and Inclusion

Davies is committed to being a diverse and inclusive workplace. We welcome candidates of all genders, gender identity and expression, neurodiversity, sexual orientation, disability, physical appearance, body size, race, age, nationality, and belief (or lack thereof).

Rewards and Recognition

We embrace innovation and run an annual competition available for all colleagues to submit their ideas. The top finalists travel to the current year’s competition site where they pitch their ideas to our investors.

The winner receives funding to bring their idea to life and the runners up receive a reward for their involvement. Some of our teammates have moved across into brand new positions to further develop their ideas / projects!

Benefits

• Medical, dental, and vision plans
• 401k plan with employer matching
• Paid Time Off, Sick Leave, and Paid Holidays
• Life insurance, short term, and long-term disability plans
• Amazing leadership and fabulous teammates

Position Type, Work Environment and Physical Demands

This is a home-based, full time, salaried, exempt position that predominantly operates remotely from a professional home-based office environment routinely using standard office equipment such as computers, phones, printers, photocopiers, and scanners and requires prolonged periods of sitting at a desk while working on a computer.

While performing the duties of this job, the individual will be required to regularly hear and talk. This is a largely sedentary role requiring the ability to sit at a desk, reach outward, use a phone, have use of fingers to operate office equipment such as a keyboard, mouse, phone, printer, copier, and to reach above the head, bend, or stand as necessary.

Application Information

Application deadline : September 20, 2024

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