Description
Davies Claims North America is seeking an experienced Lost Time Adjuster to investigate and manage Workers' Compensation claims. As a key member of the team, you will work with assigned clients, provide benefits, and ensure timely state filings.
Responsibilities:
- Adjust claims for assigned Davies Claims North America TPA clients
- Conduct thorough investigations, including 24-hour contact with employees, employers, physicians, and witnesses
- Evaluate claim details, Florida Statutes, and case law to determine compensability and total claim value
- Set and adjust reserve amounts accordingly
- Initiate accurate indemnity payments and maintain diaries for ongoing payments
- Ensure timely and proper completion of all required State filings
- Handle EDI filings and rejections with the EDI adjuster
- Monitor medical treatment with the assigned Nurse Case Manager
- Review, document, and approve medical bills for payment within three days of receipt
- Authorize appropriate medical services as outlined in Florida Statute 440.13
- Maintain regular telephone contact with injured employees
- Determine whether vocational rehabilitation services are needed for an employee to return to work
Requirements:
- At least 1-3 years of experience handling Workers' Compensation claims
- Working knowledge of Workers' Compensation Statutes and Rules and their application
- Proactive and independent with excellent problem-solving skills, attention to detail, and organization abilities
This is a full-time hybrid position requiring onsite attendance three days a week at our client's office in Palm Beach County, Florida, with the remaining two days worked remotely.