Workers' Compensation Claims Adjuster

Location

Irvine, California, United States

Salary

60000 - 95000 a year (US Dollars)

Description

We are looking for a highly capable Workers' Compensation Claims Adjuster to join our Workers' Compensation Claims team and work from any US Argo office or remotely from home in California.  This role will be adjudicating mostly indemnity but some medical-only workers' compensation claims in the California jurisdiction and contribute to providing superb results for our clients. As this is a temporary assignment only government-mandated benefits will be provided in addition to a base salary.

The primary duties and responsibilities of the role are:

• Working under technical direction and within significant limits and authority, adjudicate workers' compensation indemnity claims of higher technical complexity on assignments reflecting potentially with a direct impact on departmental results.
• Solving difficult problems that requires an understanding of a broader set of issues.
• Reporting to senior management and underwriters on claims trends and developments.
• Investigating claims promptly and thoroughly 
• Analyzing claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage.
• Investigating claims promptly and thoroughly, including interviewing all involved parties. 
• Managing claims in litigation 
• Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.   
• Properly setting claim reserves. 
• Identifying, assigning, and coordinating the assignment and coordination of expertise resources to assist in case resolution. 
• Preparing reports for file documentation 
• Applying creative solutions which result in the best financial outcome. 
• Negotiating settlements 
• Processing mail and prioritizing workload.  
• Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.). 
• Having an appreciation and passion for strong claim management. 

 

Core qualifications and requirements for this position include:

• 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).
• An practical knowledge of workers compensation claims through:
  • A minimum of four years’ experience adjudicating indemnity workers' compensation claims in the California jurisdiction. 
  • Bachelor’s degree from an accredited university required.  Two or more insurance designations or four additional years of related experience adjudicating workers compensation claims beyond the minimum experience required above may be substituted in lieu of a degree.
  • Must be licensed and have ability to quickly obtain a license in each jurisdiction requiring a license to adjudicate first party claims.

• Must have excellent communication skills and the ability to build lasting relationships.
• Exhibit natural curiosity
• Desire to work in a fast-paced environment.
• Excellent evaluation and strategic skills required.
• Strong claim negotiation skills a must.
• Must possess a strong customer focus.
• Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
• Ability to articulate the financial value of your work at multiple responsibility levels inside our clients’ business which may include CEO.
• Must work independently and demonstrate the ability to exercise sound judgment.
• Demonstrates inner strength.  Has the courage to do the right thing and demonstrates it on a daily basis.
• Intellectual curiosity.  Consistently considers all options and is not governed by conventional thinking.
• Proficient in MS Office Suite and other business-related software.
• Polished and professional written and verbal communication skills. 
• The ability to read and write English fluently is required. 
• Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.

 

Physical Demands

Unless otherwise specified below as an essential function of the job, this role generally operates within a standard office environment requiring the use of a PC and other related office equipment.

 

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.
• Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is. 
• 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. We encourage talented people from all backgrounds to apply.

How We Work - Our Employee Values

Employees at Argo thrive together as a responsible, profitable specialty insurer where all stakeholders share in our success.  
We are committed to:

• Demonstrate entrepreneurial spirit:
  • Get the job done in a non-bureaucratic, resourceful manner.
  • Create a culture of accountability ensuring the delivery of world-class products and services.
• Do the right thing:
  • Act with integrity always.
  • Adhere to the commitments set forth in the Argo Group Environmental, Social and Governance program.
• Collaborate:
  • Create an open and transparent environment in which diverse experience, skill sets, and individuals can team together to drive optimal outcomes.
  • Encourage and include unique perspectives at all times.
• Respect each other:
  • Create an environment that promotes dialogue, mutual support and cooperation between and among all, where people are fun to be around, proud of what they do, and willing to achieve beyond normal expectations.

 

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Job type:

Remote job

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