Workers' Claims Adjuster

Overview

Argo Group International Holdings, Inc and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. ("BWS"), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions.

Job Description

A Brief Overview

We are looking for a highly capable Workers' Compensation Claims Adjuster to join our team and work from either our Rockwood, PA, Richmond, VA, Omaha, NE, or San Antonio, TX office. We are open to considering hiring a less qualified candidate (a Trainee or Associate Adjuster) and providing additional on-the-job training to bring the candidate s skill set up to an Adjuster level in the next couple of years.

We work together in the office five days a week to strengthen our culture, build team connections, and drive profitability. The position reports to a manager based in Texas and focuses on adjudicating workers  compensation indemnity and medical-only claims in the jurisdictions of DE, IL, IN, NC, NV, and WV. Our Adjusters contribute to providing superb results for our clients.

Although Rockwood underwrites general liability insurance and workers  compensation for many types of businesses, our specialty is underwriting workers  compensation insurance for the mining industry, with a focus on the coal-mining industry. Rockwood has become a leading underwriter of workers  compensation for the mining industry by offering workers  compensation insurance with a commitment to providing the best service on loss control and claims, collaborating across all departments with this common goal.

We have never been more committed to our clients to ensure their employees receive excellent medical care if they need it due to a work-related injury or illness. Our passion for outstanding customer focus, combined with our deep industry experience, is what sets us apart from other insurance carriers in this niche market.

The primary duties and responsibilities of the role are:

• Working under technical direction and within significant limits and authority, adjudicate indemnity and federal black lung workers  compensation claims of higher technical complexity with a direct impact on departmental results. The amount of direction, limits and authority will initially vary depending on the skill set of the person hired into this role. In addition, adjudicate medical-only claims reported by the account as well.
• Providing laser-focused customer service to our clients by providing superior claims outcomes and developing meaningful and long lasting connections with our insured and brokers.
• Resolving issues that are generalized and typically not complex, but require understanding of a broader set of issues.
• Reporting to claims management and underwriters on claims trends and developments.
• Identifying loss drivers and claims trends to reduce claims frequency and severity through data analysis and improved claim management.
• 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.
• Creates and reviews reserves in line with market and Argo s reserving policy
• 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.
• Settles straightforward claims in line with authority limits and adheres to organizational referral procedures
• Negotiates in a timely and effective manner to provide cost effective solutions for the company and its customers within own limits using a range of negotiation styles.
• 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:

• Practical knowledge of workers  compensation claims, as well as an exceptional customer service focus typically obtained through:
  • Bachelor s degree from an accredited university required. Trainee candidates can substitute four years of general work experience for a degree. For Associate Adjuster or Adjuster candidates, two or more insurance designations or four additional years of related experience adjudicating workers  compensation claims beyond the minimum experience required below may be substituted in lieu of a degree.
  • A minimum of two years  experience…