Davies
Job Details
Department: Claims Administration & Adjusting
Location: Lakewood Ranch, FL
Compensation: $78,000 - $88,000 / year
Our Story Imagine being part of a team that’s not just shaping the future but actively driving it. At
Davies North America , we’re at the forefront of innovation and excellence, blending cutting‑edge technology with top‑tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.
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.
This position is onsite located in Largo, FL.
Key Responsibilities
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 when 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 within 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 Davies Claims North 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 FL Workers’ Compensation Statutes and Rules, and their application
Direct defense counsel in handling of litigation claims
With defense input, make timely decisions regarding litigated issues
Protect Medicare’s interest in conjunction with MMSEA Section 111 Reporting requirements
Review claims for possible red flags
Demonstrate capability of identifying and pursuing subrogation, contribution, indemnification, or other opportunities to compel responsible third parties to bear their share of the settlement burden
Request reimbursement at least quarterly and follow up for timely receipt from excess carrier(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
Skills, Knowledge & Expertise
3-5 years of Lost Time/Legal claims handling experience; preferred 5+ years
Possess FL-All Lines Adjuster or Workers’ Compensation License and maintain CEU credits for license
Previous experience with settling claims
Experience with Microsoft Office Suite
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 all levels within an organization
Benefits
Medical, dental, and vision plans to ensure your health and that of your family.
A 401(k) plan with employer matching to help you build a secure financial future.
Our time‑off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non‑exempt employees, reflect our commitment to promoting a healthy work environment.
Paid holidays.
Life insurance and both short‑term and long‑term disability plans, providing essential financial protection for you and your loved ones.
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.
Seniority Level Entry level
Employment Type Full‑time
Job Function Human Resources
Industries Insurance
Referrals increase your chances of interviewing at Davies by 2x
Get notified about new Workers' Compensation Specialist jobs in
Largo, FL .
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr
Location: Lakewood Ranch, FL
Compensation: $78,000 - $88,000 / year
Our Story Imagine being part of a team that’s not just shaping the future but actively driving it. At
Davies North America , we’re at the forefront of innovation and excellence, blending cutting‑edge technology with top‑tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.
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.
This position is onsite located in Largo, FL.
Key Responsibilities
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 when 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 within 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 Davies Claims North 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 FL Workers’ Compensation Statutes and Rules, and their application
Direct defense counsel in handling of litigation claims
With defense input, make timely decisions regarding litigated issues
Protect Medicare’s interest in conjunction with MMSEA Section 111 Reporting requirements
Review claims for possible red flags
Demonstrate capability of identifying and pursuing subrogation, contribution, indemnification, or other opportunities to compel responsible third parties to bear their share of the settlement burden
Request reimbursement at least quarterly and follow up for timely receipt from excess carrier(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
Skills, Knowledge & Expertise
3-5 years of Lost Time/Legal claims handling experience; preferred 5+ years
Possess FL-All Lines Adjuster or Workers’ Compensation License and maintain CEU credits for license
Previous experience with settling claims
Experience with Microsoft Office Suite
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 all levels within an organization
Benefits
Medical, dental, and vision plans to ensure your health and that of your family.
A 401(k) plan with employer matching to help you build a secure financial future.
Our time‑off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non‑exempt employees, reflect our commitment to promoting a healthy work environment.
Paid holidays.
Life insurance and both short‑term and long‑term disability plans, providing essential financial protection for you and your loved ones.
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.
Seniority Level Entry level
Employment Type Full‑time
Job Function Human Resources
Industries Insurance
Referrals increase your chances of interviewing at Davies by 2x
Get notified about new Workers' Compensation Specialist jobs in
Largo, FL .
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr