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Argo Group · 1 day ago

Workers' Compensation Claims Adjuster

Rockwood, PA

Full-time

Onsite

Entry, Mid Level

1+ years exp

Argo Group is a leading wealth solutions provider focused on securing financial futures through various services. They are seeking a Workers’ Compensation Claims Adjuster to adjudicate indemnity and medical-only claims for their mining account, providing excellent customer service and managing claims effectively.

MobileSoftware

No H1B

Responsibilities

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, loss control 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

Creating and reviewing 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

Qualification

Workers' compensation claimsCustomer service focusClaims negotiation skillsData analysisMS Office SuiteEffective communicationTime managementProblem-solvingRelationship buildingAdaptability

Required

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 adjudicating indemnity workers' compensation claims is required for Adjuster-level candidates. For Associate Adjuster level candidates, one year experience adjudicating indemnity workers' compensation claims is required. No work experience is required for Trainee level candidates (unless substituting general work experience for a degree as noted above). Working knowledge of the IL, IN, KY, NY, PA, and VA jurisdictions is not required, but considered a considerable plus)

Must be licensed in KY and NY or have ability to obtain a license to adjudicate first party claims in those states within 90 days of being hired

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)

Adjuster and Associate Adjuster candidates must exhibit the ability to regularly exercise discretion and independent judgment with respect to matters of significance. Trainee level candidates will be paid hourly and are not expected to have the skills or knowledge to exercise discretion or independent judgment due to their limited claims experience. This role primarily faces problems and issues that generalized and typically not complex, but require an understanding of a broader set of issues

A strong focus on execution in getting things done right. Proven ability to consistently produce and deliver expected results to all stakeholders by:

Finding a way to achieve success through adversity

Being solution (not problem) focused

Thinking with a global mindset first

Client focus – the ability to effectively determine specific client needs and to provide value added solutions

Successful traits (flexibility, ability to thrive in change, being resourceful on your own) necessary to work in a fast paced environment that is evolving constantly

Ability to develop and maintain productive relationships with clients, business partners and organizational peers with a focus on timely and meaningful exchanges of information

Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines

Exhibit natural and intellectual curiosity in order to consistently explore and consider all options and is not governed by conventional thinking

Excellent evaluation and strategic skills required

Strong claim negotiation skills a must. Ability to take proactive and pragmatic approach to negotiation. Negotiation skills will be taught to Trainee level candidates. Associate Adjuster candidates are expected to have a working understanding of negotiation skills that will be further honed with additional training

Demonstrates an understanding of mechanisms available for resolving claims settlement disputes (e.g. arbitration and mediation) and when these are used

Adjuster level candidates should have the ability to articulate the financial value of your work at multiple responsibility levels inside our clients' business which may include CEO

Demonstrates inner strength. Has the courage to do the right thing and demonstrates it on a daily basis

Proficient in MS Office Suite and other business-related software

Uses listening and questioning techniques to effectively gather information from insureds and claimants

Polished and professional written and verbal communication skills. Presents information clearly, concisely, and accurately

The ability to read and write English fluently is required

Must demonstrate a desire for continued professional development through continuing education and self-development opportunities