Senior Workers' Compensation Claims Adjuster

Business Title(s): Senior Workers' Compensation Claims Adjuster

Employment Type: Full-Time

FLSA Status: Exempt

Location: In-Office

Summary:

We are looking for a highly capable Senior Workers' Compensation Claims Adjuster to join our Claims team and work from either our Rockwood, PA or Omaha, NE offices. Alternatively, we can also fill this role in our offices in Richmond, VA or Springfield, MO. The position reports to a manager based in Rockwood, PA. This role will be adjudicating workers' compensation claims in the jurisdictions of CO, KS, KY, MD, MI, MO, MT, PA, UT, and WV and contribute to providing superb results for our clients. Approximately 20% of the claims assigned to this position are covered by the federal black lung program.

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 up apart from other insurance carriers in this niche market.

This is a 100% in-office position. Candidates must be able to work on-site at a designated company office during standard business hours.

Essential Responsibilities:

• Working under limited technical direction and within broad limits and authority, adjudicate highly complex indemnity and federal black lung workers' compensation claims on assignments reflecting potentially with significant impact on departmental results. 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.

• Solving difficult problems that requires an understanding of a broader set of issues.

• Reporting to senior 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

• Analysing 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.

• Settling straightforward claims in line with authority limits and adheres to organizational referral procedures

• Negotiating 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.

Qualifications / Experience Required:

• 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).

• An advanced knowledge of workers' compensation claims through:

• A minimum of five years' experience adjudicating workers' compensation claims in any of the following jurisdictions: CO, KS, KY, MD, MI, MO, MT, PA, UT, and/or WV.

• Bachelor's degree from an accredited university required. Two or more insurance designations or four additional years of related experience adjudicating workers' compensation claims beyond the minimum experience required above may be substituted in lieu of a degree.

• Must be licensed in KY or have ability to quickly obtain a license to adjudicate first party claims.

• Must have excellent communication skills and the ability to build lasting relationships.

• Ability to regularly exercise discretion and independent judgment with respect to matters of significance. This role primarily faces problems and issues that are difficult that requires an understanding of a broader set of issues.

• Strong claim negotiation skills a must. Ability to take proactive and pragmatic approach to negotiation.

• 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.

• Excellent evaluation and strategic skills required.

• 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.

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

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

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

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

• Proficient in MS Office Suite and other business-related software.

• Polished and professional written and verbal communication skills.

• 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.

About Working in Claims at Argo Group

Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.

We have a very flat organizational structure, enabling our employees have more interaction with our senior management team, especially when it relates to reviewing large losses.