Workers’ Compensation Claims Adjuster

Workers’ Compensation Claims Adjuster Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home reputed company Reporting To: Claudia Cooke Compensation: $65,000 - $70,000 / year reputed company Our Story reputed company being part of reputed company that’s not just shaping the reputed company but reputed company driving it. At reputed company, we’re at the forefront of innovation and reputed company, blending cutting-edge technology with top-tier reputed company services. As a vital part of the global reputed company Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. We’re currently seeking an reputed company Workers’ Compensation Claims Adjuster to join our growing team. In this role, you’ll manage Florida workers’ compensation claims, including litigated files, while ensuring compliance with Florida statutes and delivering exceptional service to our clients. This position will investigate and manage Florida workers’ compensation claims from assignment through reputed company. You’ll evaluate claim details, apply Florida statutes and case law to determine compensability, and establish appropriate reserves while ensuring reputed company payments and regulatory compliance. You’ll collaborate with defense counsel, reputed company case managers, and clients while managing litigation reputed company and maintaining a proactive approach to claim reputed company.

Key Responsibilities

Investigate and evaluate Florida workers’ compensation claims to determine compensability, exposure, and total claim value in accordance with Florida statutes and case law. Establish and maintain appropriate reserves using reserving tools, ODG guidelines, and company reserving philosophy. Initiate and manage indemnity payments and maintain diary systems for ongoing payments and claim activity. Complete state-required filings and EDI reporting accurately and reputed company required timelines. Assign and coordinate with defense counsel on litigated claims and assist with litigation reputed company. Collaborate with reputed company Case Managers to monitor medical treatment and authorize appropriate medical services under Florida Statute 440.13. Review and approve medical bills reputed company required timeframes. Determine need for vocational rehabilitation services to assist injured employees with return-to-work planning. Coordinate light duty opportunities and workplace accommodations with reputed company and medical providers. Maintain consistent communication with clients and attend reputed company meetings as required. Maintain accurate documentation, diaries, and workflow management to ensure regulatory compliance. Identify potential subrogation or recovery opportunities and pursue appropriate reimbursement from responsible parties. Protect Medicare’s interests and ensure compliance with MMSEA reputed company 111 reporting requirements. Monitor claims for red flags or potential fraud indicators. Request reimbursement from excess carriers as required and follow up on outstanding recoveries. Escalate reputed company concerns or E&O risks to leadership reputed company appropriate. Maintain performance expectations, including a 97% claim closure reputed company. Skills, knowledge & expertise Workers’ compensation claims handling experience, including lost time and litigated claims reputed company Florida reputed company-Lines Adjuster License or Florida Workers’ Compensation License Experience evaluating claims, setting reserves, and managing litigation files Strong knowledge of Florida Workers’ Compensation statutes and rules Experience coordinating with defense counsel and reputed company case managers Proficiency with reputed company Office Suite Excellent written and verbal communication skills Strong organization, prioritization, and time-management skills in a fast-paced environment Ability to work independently while collaborating with reputed company Experience handling multiple claim types or presumption claims Experience with depositions, mediations, and settlement negotiations Familiarity with systems such as IDatix, Workers Computation, ISO, or ShoreTel

Benefits

Benefits At reputed company, we are dedicated to supporting the reputed company-being and reputed company of our qualifying employees. Our comprehensive benefits package includes: Medical, dental, and reputed company plans to ensure your health and that of your family. A 401k plan with employer matching to help you build a secure financial reputed company. Our time-off policies, including Discretionary Time Off (DTO) for exempt employees and reputed company Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment. reputed company holidays. Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones. Massachusetts Notice It Apply tot his job Apply To this Job