Workers Compensation Claims Adjuster

Position Summary

The Workers’ Compensation Claims Adjuster investigates, evaluates, negotiates, and resolves workers’ compensation lost-time claims. This position serves as a key resource for members, providers, injured workers, attorneys, and other stakeholders while ensuring claims are managed effectively and in compliance with Florida law.

Essential Responsibilities

• Determine coverage and compensability of workers’ compensation claims.
• Review and establish claim files upon receipt of First Notice of Injury.
• Conduct thorough investigations by obtaining information from claimants, employers, witnesses, medical providers, attorneys, and other relevant parties.
• Obtain recorded statements when necessary.
• Evaluate claims and make sound decisions regarding reserves, compensability, and settlement opportunities.
• Negotiate settlements through telephone and written communications.
• Resolve claims within established settlement authority.
• Maintain accurate and complete claim documentation.
• Manage diaries and follow-up activities to ensure timely claim handling.
• Pursue subrogation, SDF recoveries, and other recovery opportunities.
• Participate in training and continuing education to maintain industry knowledge and compliance.
• Maintain confidentiality and professionalism in all aspects of claim handling.

Qualifications

• Strong knowledge of Florida Workers’ Compensation laws and regulations.
• Ability to investigate, evaluate, negotiate, and resolve claims effectively.
• Strong analytical and decision-making skills.
• Ability to interpret insurance policies, legal documents, and medical records.
• Excellent verbal and written communication skills.
• Ability to build professional relationships with members, injured workers, attorneys, medical providers, and colleagues.
• Strong organizational skills with the ability to manage multiple priorities.

Education and Experience

• Bachelor’s degree in Insurance, Business Administration, or a related field preferred; or
• High school diploma/GED with three to five years of Workers’ Compensation claims handling experience.

Equal Opportunity Employer

The Florida League of Cities is an Equal Opportunity Employer and considers all qualified applicants without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other protected status under applicable law.