Senior Claims Specialist, Workers Compensation

Ascot Group•FL, FL

2d•Hybrid

About The Position

This is an opportunity to join Ascot Group - one of the world’s preeminent specialty risk underwriting organizations. Designed as a modern-era company operating through an ecosystem of interconnected global operating platforms, we are bound by a common mission and purpose: One Ascot. Our greatest strength is a talented team who flourish in a collaborative, inclusive, and entrepreneurial culture, steeped in underwriting excellence, integrity, and a passion to find a better way, The Ascot Way. The Ascot Way guides our people and our organization. Our underwriting platforms collaborate to find creative ways to deploy our capital in a true cross-product and cross-platform approach. These platforms work as one, deploying our capital creatively through our unique Fusion Model: Client Centric, Risk Centric, Technology Centric. Built to be resilient, Ascot maximizes client financial security while delivering bespoke products and world class service — both pre- and post-claims. Ascot exists to solve for our clients’ brightest tomorrow, through agility, collaboration, resilience, and discipline. Ascot is embedding artificial intelligence (AI) and automation across the organisation to enhance decision‑making, efficiency, and quality of outcomes. In this role, you will be expected to work confidently alongside AI‑enabled tools, apply sound judgment when interpreting insights, and adapt as technology continues to evolve. We value curiosity, critical thinking, and a willingness to embrace change as part of how we work. The Senior Claims Specialist, Workers Compensation will investigate, evaluate and conclude lost time Worker’s Compensation claims of larger monetary exposure and/or complexity. This can lead to a compensability decision and managing the claims until settled. This position will report to a designated Claims Manager.

Requirements

Bachelor’s Degree or equivalent experience.
Minimum of 5 years of workers’ compensation claim handling experience in Florida
Resident Adjuster’s License in Florida
Excellent verbal and written communication skills
Strong interpersonal skills
Medical terminology knowledge a plus
Skilled at problem solving
Ability to make effective decisions and escalating when needed.
Experience with MS Office and any claim handling systems
Strong collaborative skills and ability to thrive in a fast-paced, entrepreneurial environment.
Strong organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously.
Commitment to providing top quality service to all internal and external business partners.

Nice To Haves

Medical terminology knowledge

Responsibilities

Responsible for investigating worker’s compensation claims cases from open to close and adhering to the claims processes and procedures with respect to payment, reporting, reserving, and auditing necessary for assigned caseload.
Responsible for contacting all parties involved in the claim, gathering and securing all necessary information to effectively evaluate the claim and outlining and recommending an action plan to manage the claim
Provides excellent communication with policyholders, injured workers, medical providers, brokers, and attorneys throughout the course of the claim.
Maintain a diary of all claims in a clear and concise manner by documenting all actions taken throughout the course of the claim.
Ensures that assigned claims are properly documented, reserved and processed.
Make recommendations to Claims Manager as needed with respect to reserves and excess authority.
Responsible for ensuring that payments are made in a timely manner.
Review and investigate all bills for propriety, reasonableness and medical necessity. Work with the Claim Assistant to obtain additional documentation if needed from providers.
Responsible for initiating settlement negotiations with the claimant, or claimant attorney, within their authority.
Other duties as assigned
Commitment to The Ascot Way: Embody The Ascot Way in their daily interaction with colleagues, fostering colleague engagement and development, collaboration, inclusivity, and individual accountability.

Benefits

Medical (including prescription coverage)
Dental
Vision
Health Savings Account
Commuter Account
Health Care and Dependent Care Flexible Spending Accounts
Life Insurance
AD&D
Work/Life Resources (including Employee Assistance Program)
Paid holidays
annual Paid Time Off (includes paid state /local paid leave where required)
Short-term Disability
Long-term Disability
Other leaves (e.g., Bereavement, FMLA, Adoption, Maternity, Military, Primary & Non-Primary Caregiver)
Contributory Savings Plan (401k)