Workers’ Compensation Claims Trainee

About the role

Argo Group is seeking a Workers’ Compensation Claims Adjuster Trainee to join our team, working from a home office in New Mexico or from our Omaha office. The position reports to a manager based in Rockwood, PA, and initially focuses on adjudicating medical-only claims, with eventual training on low-complexity indemnity claims. The role also manages Federal and State Black Lung claims that have already been reviewed and approved by the Department of Labor.

Responsibilities

• Under close supervision, investigate compensability, conduct claimant, employer, and provider outreach (including required alive‑and‑well checks), set reserves, deny non‑compensable claims, and ensure appropriate medical payments are made timely and accurately.
• Adjudicate medical-only claims and manage Federal and State Black Lung claims with approved schedules of benefits.
• Complete required alive‑and‑well checks for Black Lung claims and monitor biweekly or monthly benefit payments.
• Interview injured workers, insured employers, medical providers, and other relevant parties to determine compensability issues and subrogation potential.
• Deny claims that are not covered or do not meet compensability criteria and defend decisions if challenged.
• Actively manage medical-only claims to ensure only appropriate medical bills are paid on a timely basis.
• Manage diaries and complete tasks to ensure timely and financially sound case resolution.
• Set claim reserves, identify and coordinate expertise resources, prepare reports, process mail, and prioritize workload.
• Handle telephone calls from insureds, claimants, and other parties.
• Accurately record all hours worked and submit timesheets in accordance with company policy; work overtime when required.

Qualifications

• High School diploma required.
• At least six years of experience adjudicating medical-only workers’ compensation claims or in the insurance or healthcare industry (preferably in a commercial claim department). Familiarity with medical terminology required.
• A bachelor’s degree from an accredited university can substitute for five of the six years of required experience.
• Strong business acumen, including understanding how an insurance company operates and how this role impacts profitability for Argo Group and customers.
• Excellent communication skills with the ability to build lasting relationships; polished telephone and written/verbal communication skills.
• Solution-focused mindset with the ability to achieve success through adversity.
• Excellent evaluation and strategic skills; strong customer focus and time management abilities.
• Tenacious investigative skills to interview injured workers, employers, witnesses, and healthcare providers, and research coverage and subrogation opportunities.
• Fluent English reading, writing, and speaking skills; professional telephone communication required.
• Proficient in MS Office Suite and other business-related software.
• Desire for continued professional development through continuing education and self-development opportunities.
• Must be licensed or have the ability to quickly obtain a license in each jurisdiction requiring a license to adjudicate first-party claims within 120 days.

Preferred Qualifications

• Ability to read and write Spanish fluently.
• Bachelor’s degree from an accredited university.

About Working in Claims at Argo Group

Argo Group does not treat claims or claims professionals as a commodity. The work is challenging, diverse, and impactful, with empowered adjusters and managers exercising independent discretion to develop solutions tailored to each case. The organization is flat, enabling frequent interaction with senior management, especially on large losses. The claims team collaborates closely to expedite claim resolution, fosters innovation, and rewards creative ideas. The company values inclusivity and diversity, striving to create a welcoming environment and encourages talented individuals from all backgrounds to apply.