WC Adjuster (Lifetime Medical Only)

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. 

Davies Claims Solutions operates within the rapidly expanding US segment of the Casualty & Transportation business. We provide end to end solutions for property, liability, workers’ compensation, auto claims, and more. We offer a full range of desk-led technical claims handling, adjusting, appraisals, and supply chain services.

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

Job Overview 

Davies Claims Solutions is looking for an experienced Workers’ Compensation Claims Adjuster who will be responsible for investigating and analyzing claims, determining coverage, and negotiating settlements with claimants. Reporting to the Claims Supervisor you will determine the extent of insurance coverage and compensability on each filed workers’ compensation claim.  

To be successful in this role, you need to possess high level attention to detail and problem-solving skills and demonstrate the exceptional capability to multi-task and prioritize with excellent organization and documentation skills in a fast-paced, dynamic work environment. You must have at least 3 to 5 years of experience handling Workers’ Compensation claims and a college degree or equivalent business experience. Additionally, you must have superb communication skills, both verbal and written, conducted in a timely manner, and exhibit discretion with sensitive and confidential information. This role is a full-time remote position.

Responsibilities and Duties

• Determine the extent of insurance coverage and compensability on each filed claim
• Investigate claims, including interviewing employees, employers, and witnesses
• Obtain necessary records, including but not limited to, hospital records, police reports, and physical records
• Utilize appropriate vendor for medical bill review
• Present thorough and accurate reports to clients and excess carriers on claims investigations and situations   
• Negotiate settlements for resolutions with claimants and their attorneys 
• Attend meetings, conferences, workshops, or training sessions as requested
• Review written materials to maintain current knowledge on principles, practices, and new developments in assigned work areas
• Respond to client questions and comments in a courteous and timely manner
• Exhibit company values of We are Dynamic, We are Innovative, We are Connected, and We Succeed Together
• Perform other duties as assigned

Experience and Qualifications

Required

• 3-5 years of experience handling Workers’ Compensation claims
• College degree or equivalent business experience
• Hold an active Adjuster license 
• Maintain CEU credits for required state licensing
• Exhibit capability of understanding and following oral and/or written policies, procedures, and instructions
• Maintain extensive knowledge of medical and legal terminology with a thorough understanding of legal principles 
• Demonstrate ability to conduct investigations in multi-party situation
• Ability to prepare and present accurate and reliable reports containing finding and recommendations
• Possess thorough knowledge of current principles and practices associated with claims investigations, adjustment, and related practices
• Operation of a computer using standard or customized software applications appropriate to assigned tasks
• Ability and willingness to learn quickly and utilize new skills due to rapidly changing information and/or technology
• Proficiency in Microsoft Office Suite

Knowledge, Skills, and Abilities

• Proactive, independent, and takes initiative with consistent follow through
• 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
• Excellent team player with interpersonal skills
• High level attention to detail and problem-solving skills
• Capable of working collaboratively and independently with minimal supervision
• Exhibit discretion with sensitive and confidential information
• Display a comfort level working with key people at all levels within an organization

Essential Requirements

• Must have US work rights
• Must speak English
• 3-5 years of experience handling Workers’ Compensation claims
• College degree or equivalent business experience
• Hold an active Adjuster license
• Maintain CEU credits for required state licensing
• Exhibit capability of understanding and following oral and/or written policies, procedures, and instructions
• Maintain extensive knowledge of medical and legal terminology with a thorough understanding of legal principles 
• Demonstrate ability to conduct investigations in multi-party situations
• Ability to prepare and present accurate and reliable reports containing finding and recommendations
• Possess thorough knowledge of current principles and practices associated with claims investigations, adjustment, and related practices
• Operation of a computer using standard or customized software applications appropriate to assigned tasks
• Ability and willingness to learn quickly and utilize new skills due to rapidly changing information and/or technology
• Proficiency in Microsoft Office Suite

Other Duties

This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the individual for this job and is subject to change with or without notice.

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
• Discretionary Time Off (Vacation, Sick & Safety Leave) and Paid Holidays
• Life insurance, short term, and long-term disability plans
• Amazing Executive and Senior leadership as well as fabulous teammates

Position Type, Work Environment and Physical Demands

This is a remote, 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.

Location

Davies Claims Solutions is currently able to support employees residing in the following US locations: AL, AR, CA, FL, GA, IA, ID, IL, IN, KY, LA, MA, MI, MS, MT, NC, NM, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, VT, WA, WI, WV. If you live in—or are willing to relocate at your own expense to—any of the listed locations, we look forward to your application! If there is a required or preferred location for an open role, it will be listed in the job description. Should your state not be listed, please visit https://davies-group.com/location/ to locate a subsidiary near you.

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