Davies
Overview
Department:
Claims Administration & Adjusting Employment Type:
Permanent - Full Time Location:
Home United States Reporting To:
Nicole Stephens Description Davies North America is at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. What’s in Store We’re on the lookout for a
Workers’ Compensation Claim Adjuster
to join our growing team in Florida. As a Workers’ Compensation Legal Adjuster, you will investigate assigned Florida Workers’ Compensation claims, evaluate claim detail, including Florida Statute and case law, to determine compensability and total value of the claim while setting appropriate reserves. You will also provide benefits and initiate state filings promptly while exercising discretion and independent judgement. Responsibilities
Investigate claims to determine compensability and manage appropriate reserve levels. Oversee and direct defense counsel in litigated matters; make strategic litigation decisions. Process indemnity payments and authorize medical treatment per FL Statute 440.13. Monitor medical care and coordinate with Nurse Case Managers, medical providers, and employers on RTW and light duty. Ensure timely and compliant state and EDI filings; manage EDI rejections in coordination with EDI adjusters. Evaluate and process medical bills; identify subrogation and recovery opportunities. Maintain file documentation, diaries, and reserve worksheets in accordance with Davies’ best practices. Ensure Medicare compliance per MMSEA Section 111. Maintain a 97% claim closure rate and support client communication and satisfaction. Qualifications
3-5 years of Lost Time/Legal claims handling experience Possess FL-All Lines Adjuster or Workers’ Compensation License and maintain CEU credits for license Previous experience with settling claims In-depth knowledge of
Florida Workers’ Compensation laws and litigation process . Experience managing litigated claims with strategic oversight. Strong communication, negotiation, and analytical skills. Experience with IDatix, Reference Books-Periodicals, Workers Computation, ISO, ShoreTel a plus Benefits
Benefits Davies North America offers a comprehensive benefits package to support the well-being and financial security of qualifying employees, including: Medical, dental, and vision plans for employees and their families. A 401k plan with employer matching. Discretionary Time Off for exempt and Paid Time Off (PTO) for non-exempt employees. Paid holidays. Life insurance and short-term and long-term disability plans. Diversity and Inclusion
Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.
#J-18808-Ljbffr
Department:
Claims Administration & Adjusting Employment Type:
Permanent - Full Time Location:
Home United States Reporting To:
Nicole Stephens Description Davies North America is at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. What’s in Store We’re on the lookout for a
Workers’ Compensation Claim Adjuster
to join our growing team in Florida. As a Workers’ Compensation Legal Adjuster, you will investigate assigned Florida Workers’ Compensation claims, evaluate claim detail, including Florida Statute and case law, to determine compensability and total value of the claim while setting appropriate reserves. You will also provide benefits and initiate state filings promptly while exercising discretion and independent judgement. Responsibilities
Investigate claims to determine compensability and manage appropriate reserve levels. Oversee and direct defense counsel in litigated matters; make strategic litigation decisions. Process indemnity payments and authorize medical treatment per FL Statute 440.13. Monitor medical care and coordinate with Nurse Case Managers, medical providers, and employers on RTW and light duty. Ensure timely and compliant state and EDI filings; manage EDI rejections in coordination with EDI adjusters. Evaluate and process medical bills; identify subrogation and recovery opportunities. Maintain file documentation, diaries, and reserve worksheets in accordance with Davies’ best practices. Ensure Medicare compliance per MMSEA Section 111. Maintain a 97% claim closure rate and support client communication and satisfaction. Qualifications
3-5 years of Lost Time/Legal claims handling experience Possess FL-All Lines Adjuster or Workers’ Compensation License and maintain CEU credits for license Previous experience with settling claims In-depth knowledge of
Florida Workers’ Compensation laws and litigation process . Experience managing litigated claims with strategic oversight. Strong communication, negotiation, and analytical skills. Experience with IDatix, Reference Books-Periodicals, Workers Computation, ISO, ShoreTel a plus Benefits
Benefits Davies North America offers a comprehensive benefits package to support the well-being and financial security of qualifying employees, including: Medical, dental, and vision plans for employees and their families. A 401k plan with employer matching. Discretionary Time Off for exempt and Paid Time Off (PTO) for non-exempt employees. Paid holidays. Life insurance and short-term and long-term disability plans. Diversity and Inclusion
Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.
#J-18808-Ljbffr