Workers' Compensation Claims Adjuster

Summary

Join Argo Group as a Workers' Compensation Claims Adjuster and work remotely from home in California or from any US Argo office. This temporary position involves adjudicating workers' compensation claims, primarily indemnity but also some medical-only cases within the California jurisdiction. You will investigate and analyze claims, manage litigation, negotiate settlements, and prepare reports. A bachelor's degree or equivalent experience is required, along with at least four years of experience adjudicating indemnity workers' compensation claims in California. Excellent communication and negotiation skills are essential. Government-mandated benefits will be provided, in addition to a base salary.

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 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 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
• Have intellectual curiosity. Consistently considers all options and is 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 on assignments reflecting potentially with a direct impact on departmental results
• Solve difficult problems that requires 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 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

Benefits

• Government-mandated benefits will be provided in addition to a base salary
• Competitive compensation and merit driven profit sharing
• Workplace policies that support employee well-being include flex time and floating holidays
• 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
• Argo Academy, a digital and instructor-led platform that offers continuous learning and professional development – Training magazine lists Argo among the Training "Top 125" Companies. Argo encourages career mobility and continuing education to pursue and maintain professional and industry designations, in addition to traditional university and higher education programs
• An inclusive culture that develops and sponsors diverse teams, encourages cross-functional engagement and collaboration, builds community through employee resource groups (ERGs), and provides an environment that welcomes ongoing dialogue, creative innovation, professional and personal development
• Active community outreach and volunteer programs
• A generous Employee Referral program that results in approximately 25% of all new hires annually