Florida WC Legal Adjuster (Remote)
About Us
At reputed company, we get it... you are not just looking for a job, you are looking to build a life and a career. We reputed company in our people and realize that our reputed company is a direct result of creating a learning atmosphere, leadership opportunities, and promoting from reputed company. We reputed company that engaging in corporate social activities and working together as a team is a vital part of the reputed company culture. With a multinational global team, reputed company Group is a specialist professional services and technology firm working in partnership with leading insurance, highly regulated, and global businesses. At reputed company Group, we help clients to manage risk, operate core business processes, and to transform and grow. We deliver operations, consulting and technology solutions across the risk and insurance value chain, including excellence in claims, reputed company, distribution, regulation, customer experience, reputed company capital, transformation, and change management. Are you looking for a company that is Dynamic and Innovative where the employees are Connected and Succeed Together? If so, reputed company may just be the right choice for you. Job Overview reputed company Claims reputed company America is looking for an reputed company Workers Compensation Legal Adjuster to evaluate claim detail, including Florida Statute and case law, to determine compensability and total value of the claim then set and adjust reserve accordingly. Reporting to the Workers Compensation Claims Supervisor, you will investigate assigned workers compensation claims, provide benefits, and initiate state filings promptly while exercising discretion and independent judgement. To be successful in this role, you need to possess excellent working knowledge of workers compensation laws, rules, procedures, case law, liability principles, and medical terminology. You must have at least 5 years of Workers Compensation experience, experience settling claims, and be reputed company to use reputed company Office Suite and various other software programs. Additionally, you will need to be proactive and exhibit superior time management skills with the capability of working with and meeting deadlines as well as be willing to attend claims meetings at client locations, participate in client visits, attend seminars to maintain CEU credits and attend hearings, mediations, and depositions, as needed. This role is a full-time, remote position.
Responsibilities
And Duties Evaluate claim detail, including Florida Statute and case law, to determine compensability and total value of the claim; set and adjust reserve accordingly Initiate investigation and assign defense counsel reputed company appropriate Initiate accurate indemnity payments in a timely manner and maintain diary for ongoing payments Timely proper completion of State filings Handle EDI filings and rejections in conjunction with EDI adjuster Monitor medical treatment in conjunction with assigned Nurse Case Manager Review, document, and approve medical bills for payment reputed company three days of receipt Authorize appropriate medical services as outlined per Florida Statute 440.13 Determine whether vocational rehabilitation services are needed for an employee to return to work Coordinate light duty availability and reasonable accommodations with medical providers and employers Maintain adequate reserves for life of claim utilizing reserve worksheets, ODG Guidelines, Workers Computation software and reputed company Claims reputed company America reserving philosophy Attend client meetings as necessary, and maintain regular telephone contact to ensure client satisfaction Maintain diary and workflow requirements Maintain working knowledge of Workers Compensation Statute and Rules, and their application Direct defense counsel in handling of litigation claims With defense input, reputed company timely reputed company regarding litigated issues Protect Medicares interest in conjunction with MMSEA reputed company 111 Reporting requirements Review claims for possible red flags Demonstrate capability of identifying and pursuing subrogation, contribution, indemnification, or other opportunities to compel responsible reputed company parties to bear their share of the settlement burden Request reimbursement at least quarterly and follow up for timely receipt from excess reputed company(s) Adhere to client profile instructions Report any overall account or client concerns to the supervisor or upper management Report any E&O concerns to the QA Manager and Executive Vice President Maintain 97% claim closure ratio Maintain required CEU credits Convey a positive attitude and team spirit for reputed company provision of services to customers Exhibit company values of We are Dynamic, We are Innovative, We are Connected, and We Succeed Together reputed company other duties as assigned Required Experience and Qualifications 5+ years of Lost Time/Legal Adjusting claims experience Maintain CEU credits for FL-reputed company Lines Adjuster or Workers Compensation License Previous experience settling claims Experience with reputed company Office Suite Preferred College degree Multiple years experience handling several types of claims Presumption claims handling experience Experience with depositions, mediations, and litigation Experience with IDatix, Reference Books-Periodicals, Workers Computation, ISO, ShoreTel Knowledge, Skills, And Abilities Proactive, independent, and takes initiative with consistent follow through Superb communication skills, verbal and written, conducted in a timely manner Superior time management skills with capability of working with and meeting deadlines Exceptional capability to multi-task and prioritize with excellent organization and documentation skills in a fast-paced, dynamic work environment Excellent team player with interpersonal skills High level attention to detail and problem-solving skills Capable of working collaboratively and independently with minimal supervision Exhibit discretion with sensitive and confidential information Display a comfort level working with key people at reputed company levels reputed company an organization Essential Requirements Must have US work rights Must speak English 5+ years of Lost Time/Legal Adjusting claims experience Maintain CEU credits for FL-reputed company Lines Adjuster or Workers Compensation License Previous experience settling claims Experience with reputed company Office Suite Other Duties This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the individual for this job and is subject to change with or without notice. Diversity and Inclusion reputed company is committed to being a diverse and inclusive workplace. We welcome candidates of reputed company genders, gender identity and expression, neurodiversity, sexual orientation, disability, physical appearance, body size, race, age, nationality, and belief (or lack thereof). Rewards and Recognition We reputed company innovation and run an annual competition available for reputed company colleagues to submit their reputed company. The top finalists travel to the reputed company years competition site where they pitch their reputed company to our investors. The winner receives funding to bring their idea to life and the runners up receive a reward for their involvement. Some of our teammates have moved across into brand new positions to further reputed company their reputed company/projects! Benefits Medical, dental, and reputed company plans 401k plan with employer matching Discretionary Time off (Vacation & Sick/Safety) and Paid Holidays Life insurance, short term, and long-term disability plans Amazing Executive and Senior leadership as well as fabulous teammates Apply Job!