Workers' Compensation Claims Adjuster

Company

Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc.

Job Description

Business Title(s): Workers' Compensation Claims Adjuster

Employment Type:Full-Time

FLSA Status: Exempt

Location:Field (NV - Remote)

Summary:

We are seeking a Workers' Compensation Claims Adjusterto join our Claims teamand work remotely from Nevada. This role reports to a manager based in California. and focuses on adjudicating workers' compensation indemnity claims primarily in AZ, andCA, and NV and medical only workers' compensation claims in the NVjurisdiction only, directly contributing to strong outcomes for our clients.

This position is qualified as a field position.

Essential Responsibilities

• Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity within established authority and with a direct impact on departmental results.

• Resolving issues that are generalized and typically not complex, but require understanding of a broader set of issues.

• Analyzing 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 interviews, documentation review, and coverage analysis.

• Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.

• Identify loss drivers and claim trends to reduce frequency and severity through strong claim management.

• Report trends and developments to claims leadership and underwriters.

• Manage litigated files and maintain proper reserves aligned with Argo's reserving philosophy.

• Coordinate internal and external resources to support resolution strategies.

• Prepare accurate, concise file documentation and management reporting.

• Negotiates 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.

• Communicate professionally with insureds, claimants, attorneys, and internal stakeholders.

• Prioritize workload, manage correspondence, and maintain disciplined claim handling practices.

Qualifications / Experience Required:

• • Practical knowledge of workers' compensation claims, as well as an exceptional customer service focus typically obtained through:

  • Bachelor's degree ortwo insurance designations orfour additional years of Workers' Compensationadjusting experience.

  • Minimum 2 years' experienceadjudicating workers' compensation claims in AZ, CA, and/or NV.

  • Either a CA Self-Insurance or possession of both the WCCA and WCCP designations, andAZ claims certification and a NV claims license are required or must be attained within 90 days of hire for employment to continue past that date.

  • Strong business acumen and understanding of how claim outcomes impact profitability.

  • Proven ability to exercise discretion, independent judgment, and sound decision-making.

  • A strong focus on execution in getting things done right. Proven ability to consistently produce and deliver expected results to all stakeholders by:

    • Finding a way to achieve success through adversity.

    • Being solution (not problem) focused

    • Thinking with a global mindset first.

  • Client focus - the ability to effectively determine specific client needs and to provide value added solutions.

  • Successful traits (flexibility, ability to thrive in change, being resourceful on your own) necessary to work in a fast paced environment that is evolving constantly.

  • Ability to develop and maintain productive relationships with clients, business partners and organizational peers with a focus on timely and meaningful exchanges of information.

  • Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.

  • Exhibit natural and intellectual curiosity in order to consistently explore and consider all options and is not governed by conventional thinking.

  • Uses listening and questioning techniques to effectively gather information from insureds and claimants

  • Customer-focused approach with the ability to articulate claim value to stakeholders at all levels, including executives.

  • Understanding of dispute-resolution mechanisms such as mediation and arbitration.

  • Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.

  • Proficient in MS Office and relevant business software; fluent in English.

Compensation

• Nevada Pay Range: $78,336 - $92,208

Salary is location-based and commensurate with experience. All employees are eligible for annual bonuses and a comprehensive benefits package.

About Working in Claims at Argo Group

• Argo Group does not treat our claims or our claims professionals as a commodity.The work we offer is challenging, diverse, and impactful.

• Adjusters are empowered with broad authority and encouraged to develop creative, individualized solutions for each case.

• We have a very flat organizational structure, enabling our employeeshavemore 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. We encourage talented people from all backgrounds to apply.