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Workers' Compensation Claims Adjuster

Workers' Compensation Claims Adjuster

Argonaut Management Services, IncLos Angeles, CA, United States
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Argo Group International Holdings, Inc . and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. ("BWS"), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions.

Job Description

A Brief Overview

We are looking for a highly capableWorkers' Compensation Claims Adjusterto join our teamand work from any of our offices.We work together in the office five days a week in order to strengthen our culture, build team connections, and drive profitability.The position reports to a manager based in North Carolina and is focused on adjudicating workers' compensation indemnity claims in the jurisdictions of AL, DC, FL, GA, KY, ME, MS, NC, NH, SC, and TN and contribute to providing superb results for our clients.

The primary duties and responsibilities of the role are :

Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity with a direct impact on departmental results.

Resolving issues that are generalized and typically not complex, but require understanding of a broader set of issues.

Reporting to claims management and underwriters on claims trends and developments.

Identifying loss drivers and claims trends to reduce claims frequency and severity through data analysis and improved claim management.

Investigating claims promptly and thoroughly

Analyzing claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage.

Investigating claims promptly and thoroughly, including interviewing all involved parties.

Managing claims in litigation

Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.

Creates and reviews reserves in line with market and Argo's reserving policy

Identifying, assigning, and coordinating the assignment and coordination of expertise resources to assist in case resolution.

Preparing reports for file documentation

Applying creative solutions which result in the best financial outcome.

Settles straightforward claims in line with authority limits and adheres to organizational referral procedures

Negotiates in a timely and effective manner to provide cost effective solutions for the company and its customers within own limits using a range of negotiation styles.

Processing mail and prioritizing workload.

Completing telephone calls and written correspondence to / from various parties (insured, claimant, etc.).

Having an appreciation and passion for strong claim management.

Core qualifications and requirements for this position include :

Practical knowledge of workers' compensation claims typically obtained through :

Bachelor's degree from an accredited university required. Two or more insurance designations or four additional years of related experience adjudicating workers' compensation claims beyond the minimum experience required above may be substituted in lieu of a degree.

A minimum of two years' experience adjudicating workers' compensation claims in the jurisdictions of AL, DC, FL, GA, KY, ME, MS, NC, NH, SC, and / or TN.

Must be licensed in either FL, RI, or TX and have ability to quickly obtain a license in each jurisdiction requiring a license to adjudicate first party claims.

Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers' ability to be profitable).

Ability to regularly exercise discretion and independent judgment with respect to matters of significance.This role primarily faces problems and issues that generalized and typically not complex, but require an understanding of a broader set of issues.

A strong focus on execution in getting things done right. Proven ability to consistently produce and deliver expected results to all stakeholders by :

Finding a way to achieve success through adversity.

Being solution (not problem) focused

Thinking with a global mindset first.

Client focus - the ability to effectively determine specific client needs and to provide value added solutions.

Successful traits (flexibility, ability to thrive in change, being resourceful on your own) necessary to work in a fast paced environment that is evolving constantly.

Ability to develop and maintain productive relationships with clients, business partners and organizational peers with a focus on timely and meaningful exchanges of information.

Must have excellent communication skills and the ability to build lasting relationships.

Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.

Exhibit natural and intellectual curiosity in order to consistently explore and consider all options and is not governed by conventional thinking.

Desire to work in a fast-paced environment.

Excellent evaluation and strategic skills required.

Strong claim negotiation skills a must. Ability to take proactive and pragmatic approach to negotiation.

Must possess a strong customer focus.

Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.

Demonstrates an understanding of mechanisms available for resolving claims settlement disputes (e.g. arbitration and mediation) and when these are used.

Ability to articulate the financial value of your work at multiple responsibility levels inside our clients' business which may include CEO.

Must demonstrate the ability to exercise sound judgment working under technical direction.

Demonstrates inner strength. Has the courage to do the right thing and demonstrates it on a daily basis.

Proficient in MS Office Suite and other business-related software.

Uses listening and questioning techniques to effectively gather information from insureds and claimants

Polished and professional written and verbal communication skills. Presents information clearly, concisely, and accurately.

Ability to effectively network, build and maintain relationships, and establish appropriate visibility with business partner

The ability to read and write English fluently is required.

Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.

Licensed Claims Examiner (Based on state) Must be licensed or have ability to quickly obtain a license in each jurisdiction requiring a license to adjudicate first party claims. within 120 Days

The base salary range provided below is for hires in those geographic areas only and will be commensurate with candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, all employees are eligible for an annual bonus based on company and individual performance as well as a generous benefits package.

Albany and Chicago Pay Range : $84,500 - $99,500

Los Angeles and New York City Pay Range : $92,000 - $108,400

About Working in Claims at Argo Group

Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.

Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is.

We have a very flat organizational structure, enabling our employees have more interaction with our senior management team, especially when it relates to reviewing large losses.

Our entire claims team works in a collaborative nature to expeditiously resolve claims. We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas.

We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.

PLEASE NOTE :

Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.

If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at 210-321-8400.

Notice to Recruitment Agencies :

Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited. BWS and / or its affiliates will not be responsible for any fees associated with unsolicited submissions.

We are an Equal Opportunity Employer. We do not discriminate on the basis of age, ancestry, color, gender, gender expression, gender identity, genetic information, marital status, national origin or citizenship (including language use restrictions), denial of family and medical care leave, disability (mental and physical) , including HIV and AIDS, medical condition (including cancer and genetic characteristics), race, religious creed (including religious dress and grooming practices), sex (including pregnancy, child birth, breastfeeding, and medical conditions related to pregnancy, child birth or breastfeeding), sexual orientation, military or veteran status, or other status protected by laws or regulations in the locations where we operate. We do not tolerate discrimination or harassment based on any of these characteristics.

The collection of your personal information is subject to our HR Privacy Notice

Benefits and Compensation

We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program-including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.

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