TEMP-Workers’ Claims Adjuster

Job Description

Business Title(s): TEMP–Workers’ Compensation Claims Adjuster

Employment Type: Contingent Worker

FLSA Status: Non-Exempt

Location: In-Office or Remote

We are looking for a highly capable Workers’ Compensation Claims Adjuster to join our team and work from anywhere in the United States. The position reports to a manager based in Rockwood, PA and initially will be focused on adjudicating medical-only claims and indemnity claims, in the jurisdiction of MN. In addition, this position manages both Federal and State Black Lung claims that have already been reviewed and a schedule of benefits approved by the Department of Labor.

This role investigates compensability, conducts claimant, employer, and provider outreach (including required alive‑and‑well checks), sets reserves, denies non‑compensable claims, and ensures appropriate medical payments are made timely and accurately. The position emphasizes strong claim management fundamentals, timely resolution, thorough documentation, and consistent communication with all claim stakeholders.

• Working under technical direction and within significant limits and authority, adjudicate workers' compensation claims of higher technical complexity, with a direct impact on departmental results. This requires conducting thorough claim investigations by interviewing injured workers, insured employers, medical providers, and other relevant parties to determine compensability issues and subrogation potential.
• Manage medical‑only claims, including Federal and State Black Lung claims that have already been reviewed and a schedule of benefits approved by the Department of Labor.
• Complete required alive‑and‑well checks for Black Lung claims and monitor biweekly or monthly benefit payments.
• Resolve issues that are generalized and typically not immediately evident, but not complex and within immediate job area.
• Deny any claims that are not covered or do not meet compensability criteria and successfully defend that decision if challenged.
• Actively manage medical only claims to ensure only medical bills appropriate to the claim are paid on a timely basis.
• Manage a diary and complete tasks to ensure that cases are resolved timely and at the right financial outcome.
• Properly set claim reserves.
• Identify and direct the assignment and coordination of expertise resources to assist in case resolution.
• Prepare reports for file documentation.
• Process mail and prioritize workload.
• Handle telephone calls from various parties (insured, claimant, etc.).
• Maintain an appreciation and passion for strong claim management.

• A practical knowledge of adjudicating workers' compensation claims through:
  • A minimum of five years’ experience adjudicating workers' compensation claims in MN
  • Bachelor’s degree from an accredited university required. Two or more insurance designations or four additional years of related experience adjudicating indemnity claims beyond the minimum experience required above may be substituted in lieu of a degree.
• 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).
• 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…