Workers' Compensation Claims Adjuster

Summary

Join Argo Group as a highly capable Workers' Compensation Claims Adjuster to adjudicate workers' compensation indemnity claims and contribute to providing superb results for our clients.

Requirements

• 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)
• An practical knowledge of workers compensation claims through: A minimum of four years ’ experience adjudicating indemnity workers' compensation claims in the California jurisdiction
• 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
• Must be licensed and have ability to quickly obtain a license in each jurisdiction requiring a license to adjudicate first party claims
• Must have excellent communication skills and the ability to build lasting relationships
• Exhibit natural curiosity
• Desire to work in a fast-paced environment
• Excellent evaluation and strategic skills required
• Strong claim negotiation skills a must
• Must possess a strong customer focus
• Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines
• Ability to articulate the financial value of your work at multiple responsibility levels inside our clients’ business which may include CEO
• Must work independently and demonstrate the ability to exercise sound judgment
• Demonstrates inner strength. Has the courage to do the right thing and demonstrates it on a daily basis
• Intellectual curiosity. Consistently considers all options and is not governed by conventional thinking
• Proficient in MS Office Suite and other business-related software
• Polished and professional written and verbal communication skills
• 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

Responsibilities

• Working under technical direction and within significant limits and authority, adjudicate workers' compensation indemnity claims of higher technical complexity on assignments reflecting potentially with a direct impact on departmental results
• Solving difficult problems that requires an understanding of a broader set of issues
• Reporting to senior management and underwriters on claims trends and developments
• 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
• Properly setting claim reserves
• 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
• Negotiating settlements
• Processing mail and prioritizing workload
• Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.)

Benefits

• Comprehensive health, wellness, and financial planning options that employees can tailor to meet their personal and family needs. In addition to traditional health and wellness plans, benefits include dental, disability, life insurance, medical, and vision insurance
• Matching 401(k) retirement savings
• Generous paid time off (21 days of PTO, 11 paid company holidays, 3 floating holidays and a paid voluntary day)
• Paid caregiver and parental leave
• Paid bereavement
• Jury duty/court appearances, and military (up to 14 days) leave
• Employee assistance program (EAP)
• And an array of voluntary benefits