Workers Compensation Adjuster - Remote FL

About the role

Charles Taylor is seeking a dynamic, experienced workers' compensation adjuster to join our Third-Party Administration team. This is a remote role for Florida residents.

Job Summary

The Workers Compensation Claims Adjuster is responsible for managing all aspects of a workers compensation claim which includes determining compensability, verifying coverage, administering disability and medical benefits, skillfully negotiating claim resolutions, troubleshooting and assisting injured employees, employers and medical/legal professionals with any service needs throughout the lifespan of a claim.

Responsibilities

• Receives newly reported claims which include loss time, litigated and medical only
• Maintains and updates claim notes throughout lifespan of claim
• Records claim information in electronic database
• Interviews claimants, insureds, medical professionals and witnesses to determine claim validity
• Communicates claim compensability decisions to claimant, employer and medical provider
• Sets appropriate reserves based on nature/extent of injury
• Calculates lost time wages, makes disability payments directly to claimants and diaries future payments as appropriate
• Orders independent medical examination as necessary and prepares all relevant documentation for physician review
• Maintains regular correspondence with claimants, insureds, and nurse case manager to include claim updates, medical appointments, or issues with disability payments
• Reviews and processes medical bills through third-party vendor for additional discount opportunities
• Aggressively collaborates with claimants and insureds to ensure early return-to-work is pursued
• Works in partnership with legal counsel to warrant that insured's interests are protected on litigated claims which includes providing all relevant claim documentation needed for defense counsel to successfully defend claim and evaluate ultimate claim exposure
• Attends settlement conferences, mediations, and hearings on behalf of the insurance company/insured
• Reviews and approves defense attorney bills within authority
• Works with underwriting to help provide relevant information on losses for renewal rates as well as Risk Management to identify trends and may interact with agents for insureds on losses
• Responds to State requests for health cost disputes, applications for hearings and penalty assessment letters
• Identifies subrogation potential and pursues recovery
• Leads claim reviews with clients as requested
• Other duties as assigned

Requirements

• 3-5 years of experience adjusting Workers Compensation Claims in Florida
• Hold a current FL adjusters license
• Must be current with CEU's
• Proficiency in entire Microsoft Office suite
• Knowledge of relevant workers compensation laws
• Strong grasp of medical terminology
• Familiarity with medical cases and how treatment typically progresses
• Excellent oral and written communication abilities
• Attention to detail and good organization skills
• Ability to negotiate issues and settlements
• Strong focus on customer service which includes timely response to requests/inquiries
• Ability to adapt to changing technologies and learn functionality of new equipment and systems
• Ability to establish and maintain effective working relationships with others

Benefits

• Medical
• Dental
• Vision
• Life insurance
• 401(K) with match

Values

At Charles Taylor, our values define our identity, principles and conduct. This person will demonstrate and champion Charles Taylor Values by ensuring Agility, Integrity, Care, Accountability and Collaboration.