Workers' Compensation Claims Adjuster

Brookfield Wealth Solutions, Ltd•Omaha, NE

6d•Onsite

About The Position

Argo Group is seeking a highly capable Workers' Compensation Claims Adjuster to join their Claims team in Omaha, NE. This role involves adjudicating Workers' Compensation claims in specific jurisdictions (AL, CO, FL, GA, KY, NC, NJ, NY, & SC) to provide excellent results for clients. Argo specializes in underwriting workers' compensation insurance for the mining industry, particularly the coal-mining industry, and is committed to providing the best service in loss control and claims. This is a 100% in-office position requiring candidates to work on-site during standard business hours.

Requirements

Practical knowledge of workers' compensation and an exceptional customer service focus.
A minimum of two years’ experience adjudicating indemnity workers' compensation claims.
Bachelor’s degree from an accredited university required. (Two or more insurance designations or four additional years of related experience adjudicating workers’ compensation claims beyond the minimum experience required may be substituted in lieu of a degree).
Must be able to obtain and retain licenses in assigned jurisdictions within 120 days of identification of need.
Must have good business acumen (understand how an insurance company works and makes money, including how this role impacts profitability).
Must have excellent communication skills and the ability to build lasting relationships.
Ability to regularly exercise discretion and independent judgment with respect to matters of significance.
Strong claim negotiation skills.
Ability to take a proactive and pragmatic approach to negotiation.
A strong focus on execution in getting things done right.
Proven ability to consistently produce and deliver expected results to all stakeholders.
Client focus – the ability to effectively determine specific client needs and to provide value-added solutions.
Excellent evaluation and strategic skills required.
Must possess a 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.
Demonstrates inner strength. Has the courage to do the right thing.
Exhibit natural and intellectual curiosity to explore and consider all options.
Demonstrates an understanding of mechanisms available for resolving claims settlement disputes (e.g. arbitration and mediation) and when these are used.
Uses listening and questioning techniques to effectively gather information from insureds and claimants.
Proficient in MS Office Suite and other business-related software.
Polished and professional written and verbal communication skills.
The ability to read and write English fluently is required.
Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.

Nice To Haves

Experience handling workers’ compensation claims in any of the following jurisdictions is strongly preferred: AL, CO, FL, GA, KY, NC, NJ, NY, & SC.

Responsibilities

Adjudicate workers’ compensation claims of higher technical complexity under technical direction and within significant limits and authority, with a direct impact on departmental results.
Provide laser-focused customer service to clients by delivering superior claims outcomes and developing meaningful connections with insureds and brokers.
Resolve issues that are generalized and typically not complex, but require understanding of a broader set of issues.
Report to senior management, loss control, 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 coverage.
Write own coverage letters.
Manage claims in litigation.
Manage diary timely and complete tasks to ensure cases move towards 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 that 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 a strong appreciation and passion for claim management.