Workers' Compensation Claims Adjuster

About the role

We are looking for a highly capable Workers’ Compensation Claims Adjuster to join our Claims team and work from either our Rockwood, PA or Omaha, NE offices. Alternatively, we can also fill this role in our offices in Richmond, VA or Springfield, MO. However, we are open to considering hiring a less qualified candidate (a Trainee or Associate Adjuster) and providing additional on-the-job training to bring the candidate’s skill set up to an Adjuster level in the next couple of years.

Responsibilities

• Working under technical direction and within significant limits and authority, adjudicate indemnity and federal black lung workers’ compensation claims of higher technical complexity with a direct impact on departmental results.
• Adjudicate medical-only claims reported by the account as well.
• Provide laser-focused customer service to our clients by providing superior claims outcomes and developing meaningful and long-lasting connections with our insured and brokers.
• Resolve issues that are generalized and typically not complex, but require understanding of a broader set of issues.
• Report to claims 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
• Analyze claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage.
• Investigate claims promptly and thoroughly, including interviewing all involved parties.
• Manage claims in litigation
• 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.).
• Have an appreciation and passion for strong claim management.

Qualifications / Experience

• Practical knowledge of workers’ compensation claims, as well as an exceptional customer service focus typically obtained through: Bachelor’s degree from an accredited university required. Trainee candidates can substitute four years of general work experience for a degree.
• For Associate Adjuster or Adjuster candidates, two or more insurance designations or four additional years of related experience adjudicating workers’ compensation claims beyond the minimum experience required below may be substituted in lieu of a degree.
• A minimum of two years' experience adjudicating indemnity workers’ compensation claims is required for Adjuster-level candidates. For Associate Adjuster level candidates, one year experience adjudicating indemnity workers’ compensation claims is required.
• No work experience is required for Trainee level candidates (unless substituting general work experience for a degree as noted above).
• Working knowledge of the IL, IN, KY, NY, PA, and VA jurisdictions is not required, but considered a considerable plus).
• Must be licensed in KY and NY or have ability to obtain a license to adjudicate first party claims in those states within 90 days of being hired.
• Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers’ ability to be profitable).
• Adjuster and Associate Adjuster candidates must exhibit the ability to regularly exercise discretion and independent judgment with respect to matters of significance.
• Trainee level candidates will be paid hourly and are not expected to have the skills or knowledge to exercise discretion or independent judgment due to their limited claims experience.

About Working In Claims

We have a very flat organizational structure, enabling our employees have more interaction with our senior management team, especially when it relates to reviewing large losses. Our entire claims team works in a collaborative nature to expeditiously resolve claims. We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas. We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone.

Benefits And Compensation

We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program—including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.