Workers' Compensation Claims Adjuster

Summary

Join Argo Group, a specialty insurance leader, as a Workers' Compensation Claims Adjuster! Work remotely from home in Los Angeles or from any US Argo office. You will adjudicate workers' compensation claims in California, focusing on indemnity and some medical-only cases. This role requires strong claim management skills, excellent communication, and a minimum of four years of experience in California workers' compensation claims adjudication. A bachelor's degree is required, or equivalent experience and certifications. Argo offers a competitive compensation package, including comprehensive benefits and a supportive work environment.

Requirements

• 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)
• Have a practical knowledge of workers compensation claims through: A minimum of four years’ experience adjudicating indemnity workers' compensation claims in the California jurisdiction
• Have a Bachelor’s degree from an accredited university
• Be licensed and have the ability to quickly obtain a license in each jurisdiction requiring a license to adjudicate first party claims
• Have excellent communication skills and the ability to build lasting relationships
• Exhibit natural curiosity
• Desire to work in a fast-paced environment
• Have excellent evaluation and strategic skills
• Have strong claim negotiation skills
• Possess a strong customer focus
• Have effective time management skills and the ability to prioritize workload while handling multiple tasks and deadlines
• Be able to articulate the financial value of your work at multiple responsibility levels inside our clients’ business which may include CEO
• Work independently and demonstrate the ability to exercise sound judgment
• Demonstrate inner strength. Have the courage to do the right thing and demonstrate it on a daily basis
• Demonstrate intellectual curiosity. Consistently consider all options and are not governed by conventional thinking
• Be proficient in MS Office Suite and other business-related software
• Have polished and professional written and verbal communication skills
• Be able to read and write English fluently
• Demonstrate a desire for continued professional development through continuing education and self-development opportunities

Responsibilities

• Adjudicate workers' compensation indemnity claims of higher technical complexity
• Solve difficult problems requiring an understanding of a broader set of issues
• Report to senior management and underwriters on claims trends and developments
• Investigate claims promptly and thoroughly
• Analyze claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage
• Investigate claims promptly and thoroughly, including interviewing all involved parties
• Manage claims in litigation
• Manage diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution
• Properly set claim reserves
• Identify, assign, and coordinate the assignment and coordination of expertise resources to assist in case resolution
• Prepare reports for file documentation
• Apply creative solutions which result in the best financial outcome
• Negotiate settlements
• Process mail and prioritize workload
• Complete telephone calls and written correspondence to/from various parties (insured, claimant, etc.)
• Have an appreciation and passion for strong claim management

Preferred Qualifications

• Two or more insurance designations
• Four additional years of related experience adjudicating workers compensation claims beyond the minimum experience required

Benefits

• Competitive compensation and merit-driven profit sharing
• Flex time and floating holidays
• Comprehensive health, wellness, and financial planning options
• 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 leave
• Paid jury duty/court appearances leave
• Paid military leave (up to 14 days)
• Employee assistance program (EAP)
• An array of voluntary benefits
• Argo Academy, a digital and instructor-led platform that offers continuous learning and professional development
• Career mobility and continuing education to pursue and maintain professional and industry designations