Claims Adjuster-Worker's

Position Overview

The Broward County Board of County Commissioners is seeking a qualified Claims Adjuster in the Risk Management Division. The role is focused on Workers’ Compensation claims and requires a detail‑oriented, customer‑focused professional.

• Investigate, evaluate, and settle insurance claims in accordance with company policies and regulatory requirements.
• Work closely with policyholders, legal representatives, and other stakeholders to ensure fair and timely resolution of claims.
• Calculate and process disability benefits for impairment ratings of 1% or more, ensuring compliance with state EDI mandates to avoid penalties.
• Set up medical claims to document and update work status and treatment plans.
• Monitor and obtain medical records and work status updates to ensure timely calculation and payment of indemnity and impairment ratings.
• Process employee‑received notices of outstanding medical bills to resolve non‑payment issues.
• Review and correct reporting by CMS for accuracy.
• Conduct field investigations and face‑to‑face statements with employees, employer representatives, and witnesses.
• Consult on injury cases with medical personnel to ascertain treatment scope, loss of earning capacity, and prognosis.
• Perform calculations and payments for benefits, including indemnity and medical benefits, and enter all payments for benefits.
• Initiate timely electronic filings to the Division of Workers’ Compensation for disabilities over 8 days.
• Authorize and coordinate medical treatment with walk‑in facilities and specialists.
• Process outgoing letters to injured employees and medical providers and place them on notice of action.
• Monitors work status for disabilities of 7 days or less through discharge for claim closure.
• Denies/process claims for non‑work‑related injuries with timely electronic filing.
• Conduct recorded interviews with employees and witnesses.
• Review and analyze reports of accidents, including property damage and bodily injury, to determine liability.
• Coordinate gathering of formal evidence by taking photographs, preparing diagrams, and making measurements at accident scenes.
• Arrange for witnesses to appear at legal proceedings and prepare accident reports.
• Negotiate claim settlements in collaboration with the Director of Risk Management, County Administrator, County Attorney, claimants, and/or their legal teams.
• Attend mediations with the County Attorney’s office to support the claims process.
• Provide advice on potential fraud, subrogation, underwriting/safety risk, and communication with counsel.
• Analyze complex information from police reports, surveillance video, audio, and other sources to further understand incidents.
• Make decisions for approval of medical treatments and property restoration.
• Determine liability or compensability for Workers’ Compensation claims and apportion liability percentages.
• Investigate liability claims and input data into the system associated with findings.
• Attend meetings with other Divisions, Human Resources, and Professional Standards/Human Rights Section on complex claims.
• Perform related work as assigned.

• Two (2) years of higher‑level education in workers’ compensation or general liability claims adjusting and insurance/risk management, or one year of relevant experience for each year of required education.
• Four (4) years of experience adjusting workers’ compensation and/or bodily injury/property damage liability claims or closely related experience.
• Possession of a Florida All‑Lines Adjuster’s License (Type 6‑20 or 7‑20) from the State of Florida Division of Insurance.
• Valid Florida Class E Driver’s License for the duration of appointment.

• Associates in Claims (AIC) Certificate
• Certified Insurance Counselor (CIC) or Chartered Property Casualty Underwriter (CPCU)
• Certification in Workers’ Compensation (CWC)
• Accredited Claims Adjuster (ACA)
• Bachelor’s degree or higher in a related field
• 2+ years of experience in recorded statements
• 2+ years of experience responding to conditional payment demands from the Center for Medicare Services
• 2+ years of experience negotiating workers’ compensation lien recoveries