TEMP-Workers’ Compensation Claims Adjuster

BP&C•Albany, NY

11d•Remote

About The Position

Argo Group is seeking a highly capable Workers’ Compensation Claims Adjuster to join their team, with the flexibility to work from anywhere in the United States. This role reports to a manager in Rockwood, PA, and will initially focus on adjudicating medical-only and indemnity claims within Minnesota jurisdiction. Additionally, the position involves managing Federal and State Black Lung claims that have already been reviewed and approved by the Department of Labor. The responsibilities include investigating compensability, conducting outreach to claimants, employers, and providers (including alive-and-well checks), setting reserves, denying non-compensable claims, and ensuring timely and accurate medical payments. The role emphasizes strong claim management fundamentals, prompt resolution, thorough documentation, and consistent communication with all stakeholders. Argo Group specializes in workers’ compensation insurance for the mining industry, particularly coal mining, and is committed to providing excellent service in loss control and claims.

Requirements

A practical knowledge of adjudicating workers' compensation claims.
A minimum of five years’ experience adjudicating workers' compensation claims in MN.
Bachelor’s degree from an accredited university.
Two or more insurance designations or four additional years of related experience adjudicating indemnity claims beyond the minimum experience required may be substituted in lieu of a degree.
Good business acumen (understanding how an insurance company works and makes money, and how this role impacts profitability).
Excellent communication skills and the ability to build lasting relationships.
Natural curiosity.
Desire to work in a fast-paced environment.
Excellent evaluation and strategic skills.
Strong claim negotiation skills.
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.
Ability to work independently and demonstrate sound judgment.
Demonstrates inner strength and courage to do the right thing.
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.
Ability to read and write English fluently.
Demonstrates a desire for continued professional development through continuing education and self-development opportunities.
Must be legally authorized to work in the United States.

Responsibilities

Adjudicate workers' compensation claims of higher technical complexity under technical direction and within significant limits and authority.
Conduct thorough claim investigations by interviewing injured workers, insured employers, medical providers, and other relevant parties to determine compensability issues and subrogation potential.
Manage medical-only claims, including Federal and State Black Lung claims that have already been reviewed and a schedule of benefits approved by the Department of Labor.
Complete required alive-and-well checks for Black Lung claims and monitor biweekly or monthly benefit payments.
Resolve issues that are generalized and typically not immediately evident, but typically not complex and within the immediate job area.
Deny claims that are not covered or do not meet compensability criteria and defend that decision if challenged.
Actively manage medical-only claims to ensure only appropriate medical bills are paid timely.
Manage a diary and complete tasks to ensure cases are resolved timely and at the right financial outcome.
Properly set claim reserves.
Identify and direct the assignment and coordination of expertise resources to assist in case resolution.
Prepare reports for file documentation.
Process mail and prioritize workload.
Handle telephone calls from various parties (insured, claimant, etc.).