Claims Adjuster - Lost Time

Responsibilities

• Determines the extent of coverage of insured individuals.
• Confirm coverage with receipt of first notice of injury, and assist in establishing files with clerical assistance.
• Secure information from members, claimants, witnesses, investigating authorities, experts, doctors, attorneys, etc. using recorded statements when necessary.
• Conduct settlement negotiations via telephone and written correspondence when required. Possesses a certain level of financial authority to settle independently.
• Evaluate and conclude office handled claims within designated monetary authority.
• Review and confirm facts and other information necessary to document the file as part of the overall investigation of claims.
• Maintain diary for follow-up on files, determination of damages, and additional investigations.
• Attends any required or necessary training sessions, courses, etc. to develop and maintain up to date knowledge and skills.
• Handle SDF recoveries, subrogation recoveries, and any other recovery that may be available as a result of investigation.
• Maintains an appropriate level of confidentiality of processed information.
• Performs other related duties as required.

Requirements

• Thorough knowledge of the applicability of relevant laws and regulations.
• Knowledge of Florida Worker’s Compensation law.
• Skill in investigating, evaluating and negotiating.
• Ability to read and interpret policy documents, technical information and procedural manuals.
• Ability to analyze all details of insurance claims and based on this analysis, make efficient and effective decisions.
• Ability to speak effectively with claimants, attorneys, etc.
• Ability to exercise independent and good judgment.
• Ability to communicate effectively to various personalities both orally and in writing.
• Ability to establish and maintain effective working relationships with department heads, managers, employees and vendors.
• Ability to manage and prioritize multiple tasks.

Qualifications

• Graduation from an accredited college or university with a degree in Insurance, Business, or a related field; or high school diploma or GED with three to five years of experience in all aspects of Worker’s Compensation claims.
• Must possess a valid Workers’ Compensation Claims license.