Florida Workers’ Compensation Adjuster – Lost Time

About Us 

At Davies, we get it... you are not just looking for a job, you are looking to build a life and a career. We believe in our people and realize that our success is a direct result of creating a learning atmosphere, leadership opportunities, and promoting from within. We believe that engaging in corporate social activities and working together as a team is a vital part of the Davies culture. 

With a multinational global team, Davies Group is a specialist professional services and technology firm working in partnership with leading insurance, highly regulated, and global businesses.  At Davies Group, we help clients to manage risk, operate core business processes, and to transform and grow. We deliver operations, consulting and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation, customer experience, human capital, transformation, and change management.  

As part of Davies Specialty Programs, PGCS specializes in Third Party Claims Administration for Workers’ Compensation and Liability claims. We pride ourselves on our friendly, team-orientated work environment. Our energetic team, supportive leaders, and can-do attitude enhance a sense of collaboration and belonging in our teammates. Our focus is on quality, professional, superior service. This service-driven philosophy, conveyed throughout the organization, means we operate with the customers’ best interests at heart, constantly reinforcing our mission – Service Beyond the Contract.

Are you looking for a company that is Dynamic and Innovative where the teammates are Connected and Succeed Together?  If so, Davies may just be the right choice for you.

Job Overview

PGCS, part of Davies Specialty Programs, is looking for an experienced Workers’ Compensation Claims Adjuster.   Reporting to the Claims Supervisor, you will be responsible for the handling of Workers’ Compensation claims for self-insured and public entity accounts, including complex and high exposure claims. This includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves.

Opportunity to work from home.

Responsibilities and Duties:

• Analyzing the claim exposure to determine the proper course of action and to appropriately settle or close the claim.
• Building and maintaining rapport with client contacts to ensure retention and client satisfaction.
• Managing and directing the claim file; including determining indemnity, calculating loss of income, evaluating the treatment plan, testing, surgery, surveillance, attorney involvement, return-to-work, light duty; appropriate calculation and timely payment of all benefits.
• Handling legal aspects of the file in negotiation of settlement; developing litigation/defense strategies with attorneys and participating in depositions, mediations, and hearings.
• Evaluating files for reserve potential and for settlement.
• Documenting and communicating all claim activity timely and effectively.
• Interacting extensively with various parties involved in the claim process.
• Managing EDI requirements per state and company protocol.
• Identifying and pursuing SDF, subrogation, fraud, vocational/field case management involvement, as necessary.
• Complying with excess carriers’ limits and reporting requirements. 
• Properly handling status reports/claim reviews with clients; travel as required.
• Performing other duties as needed.

Experience and Qualifications

• A minimum of three years of Florida claims-related experience with a consistent high level of performance and achievement.
• Experience in a claims environment handling lost time claims including litigated files.
• Active Adjuster license (FL 5-24, 5-20 or 6-20) required.

Knowledge, Skills and Abilities

• Extensive knowledge of accepted industry standards and practices including case law. Ability to successfully negotiate the settlement and disposition of claims, including the ability to interpret related documentation.  
• Superb communication skills, verbal and written, conducted in a timely manner.
• Superior time management skills with capability of working with and meeting deadlines.
• Exceptional capability to multi-task and prioritize with excellent organization and documentation skills in a fast-paced, dynamic work environment.
• Willing to travel for mediations, to accounts for status reporting, to accident scenes or loss locations for investigation purposes, as necessary.
• Ability to effectively operate a personal computer and related claims and business software.
• Good communication skills, both oral and written.
• Excellent customer service skills.  
• Assertive self-starter with excellent organizational skills. Team player. Good attendance.

Diversity and Inclusion 

Davies is committed to being a diverse and inclusive workplace. We welcome candidates of all genders, gender identity and expression, neurodiversity, sexual orientation, disability, physical appearance, body size, race, age, nationality, and belief (or lack thereof). 

Rewards and Recognition 

We embrace innovation and run an annual competition available for all colleagues to submit their ideas. The top finalists travel to the current year’s competition site where they pitch their ideas to our investors. The winner receives funding to bring their idea to life and the runners up receive a reward for their involvement. Some of our teammates have moved across into brand new positions to further develop their ideas/projects! 

Benefits 

• Medical, dental, and vision plans 
• 401k plan with employer matching 
• Paid Time Off, Sick Leave, and Paid Holidays 
• Life insurance, short term, and long-term disability plans 
• Amazing leadership and fabulous teammates 

Position Type, Work Environment and Physical Demands 

This is a home-based, full time, salaried, exempt position that predominantly operates remotely from a professional home-based office environment routinely using standard office equipment such as computers, phones, printers, photocopiers, and scanners and requires prolonged periods of sitting at a desk while working on a computer.  While performing the duties of this job, the individual will be required to regularly hear and talk.  This is a largely sedentary role requiring the ability to sit at a desk, reach outward, use a phone, have use of fingers to operate office equipment such as a keyboard, mouse, phone, printer, copier, and to reach above the head, bend, or stand as necessary. 

Application Information

Application deadline: September 30, 2024  

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