Workers’ Compensation Adjuster

Job Requirements/Responsibilities:

• 3+ years of experience working directly for an Insurance Carrier or Third Party Administrator
• 2+ years of recent experience handling Workers’ Compensation claims within the state of Florida
• Additional licenses or jurisdictional experience is a plus
• Duties to include but not limited to mid to high-level Workers’ Compensation claims to determine benefits due; to insure ongoing adjudication of claims within company standards and industry best practices
• Ability to manage subrogation of claims and negotiate settlements
• Responsible for claims management of assigned caseloads from medium to high complexity and/or moderate exposure claims, within the guidelines of published performance standards
• Analyze claims, set reserves, determine compensability, pay benefits and settle claims within established dollar authority and according to company policy and Labor Code provisions
• Assign rehabilitation referrals including early return-to-work programs
• Maximize utilization of company medical cost containment programs
• Prepare cases in litigation adequately and appropriately for MSCs and trials
• Communicate with policyholders, injured workers and others in a professional and timely manner
• Responsible for meeting specific performance objectives
• May function as an account coordinator to specific policyholders
• Settlement/reserve authority as established by management
• Strong analytical, interpretive, organizational, negotiating and interpersonal skills
• Attend educational seminars and classes as assigned