Workers' Compensation Claims Adjuster

BP&C•Omaha, NE

3d•Onsite

About The Position

Argo Group is seeking a highly capable Workers' Compensation Claims Adjuster to join their in-office team. This role is focused on adjudicating workers’ compensation indemnity claims in the jurisdictions of PA, KY and NY, contributing to superb results for clients. Experience in NJ is preferred but not required. This is a 100% in-office position, requiring candidates to work on-site at a designated company office during standard business hours.

Requirements

Bachelor’s degree required, OR two insurance designations OR four additional years of Indemnity Workers’ Compensation adjusting experience in lieu of degree.
Minimum 2 years’ experience adjudicating workers’ compensation claims in the jurisdiction of PA, KY and NY.
Must be able to obtain and retain licenses where applicable in assigned jurisdictions within 120 days of identification of need.
Strong business acumen and understanding of how claim outcomes impact profitability.
Proven ability to exercise sound judgment and independent decision-making.
A strong focus on execution in getting things done right.
Proven ability to consistently produce and deliver expected results to all stakeholders.
Ability to develop and maintain productive relationships with clients, business partners and organizational peers with a focus on timely and meaningful exchanges of information.
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.
Excellent evaluation and strategic skills required.
Strong claim negotiation skills a must.
Ability to take proactive and pragmatic approach to negotiation.
Ability to thrive in a fast-paced, evolving environment with multiple priorities.
Demonstrated customer focus.
High degree of professionalism, curiosity, integrity, and willingness to do the right thing.
Proficient in MS Office and related business systems; fluent in English.
Commitment to ongoing professional development.
Applicants must be legally authorized to work in the United States.
Candidates must be able to work on-site at a designated company office during standard business hours.

Nice To Haves

Experience in the jurisdictions of NJ is preferred but not required.
Associate Adjuster candidates are expected to have a working understanding of negotiation skills that will be further honed with additional training.

Responsibilities

Adjudicate workers’ compensation claims of higher technical complexity with a direct impact on departmental results, working under technical direction and within significant limits and authority.
Resolve issues that are generalized and typically not complex but require understanding of a broader set of issues.
Report to claims management and underwriters on claims trends and developments.
Identify loss drivers and claims trends to reduce claims frequency and severity through data analysis and improved claim management.
Investigate claims promptly and thoroughly, including interviewing all involved parties.
Analyze claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage.
Manage claims in litigation.
Manage diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
Create and review reserves in line with market and Argo's reserving policy.
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.
Settle straightforward claims in line with authority limits and adhere to organizational referral procedures.
Negotiate 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.
Process mail and prioritize workload.
Complete telephone calls and written correspondence to/from various parties (insured, claimant, etc.).
Demonstrate an understanding of mechanisms available for resolving claims settlement disputes (e.g. arbitration and mediation) and when these are used.
Use listening and questioning techniques to effectively gather information from insureds and claimants.
Articulate claim value to stakeholders, including senior leadership.