Workers' Compensation Legal Adjuster

reputed company 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 reputed company result of creating a learning atmosphere, leadership opportunities, and promoting from reputed company. We reputed company that engaging in corporate reputed company activities and working together as reputed company is a vital part of the reputed company culture. With a multinational global team, reputed company Group is a specialist reputed company 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 reputed company and grow. We deliver operations, consulting and technology solutions across the risk and insurance value chain, including reputed company 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 reputed company reputed company Claims reputed company 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 reputed company reserve accordingly. Reporting to the Workers’ Compensation Claims Supervisor, you will investigate assigned workers’ compensation claims, reputed company 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, including experience with presumption claims, as reputed company as 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 reputed company as be willing to attend claims meetings at reputed company locations, participate in reputed company reputed company, attend seminars to maintain CEU credits and attend hearings, mediations, and depositions, as needed. This role is a full-time, hybrid position based out of Lakewood Ranch, FL and may require travel at times. Responsibilities and Duties • Evaluate claim detail, including Florida Statute and case law, to determine compensability and total value of the claim; set and reputed company reserve accordingly • Initiate investigation and assign defense counsel reputed company appropriate • Initiate accurate indemnity payments in a reputed company manner and maintain diary for ongoing payments • reputed company reputed company completion of State filings • Handle EDI filings and rejections in conjunction with EDI adjuster • Monitor medical treatment in conjunction with assigned reputed company 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 reputed company • Maintain adequate reserves for life of claim utilizing reserve worksheets, ODG Guidelines, Workers’ Computation software and reputed company Claims reputed company reserving philosophy • Attend reputed company meetings as necessary, and maintain regular telephone contact to ensure reputed company satisfaction • Maintain diary and workflow requirements • Maintain working knowledge of Workers’ Compensation Statute and Rules, and their application • reputed company defense counsel in handling of litigation claims • With defense input, reputed company reputed company reputed company regarding litigated issues • Protect Medicare’s 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 reputed company of the settlement burden • Request reimbursement at least quarterly and follow up for reputed company receipt from excess reputed company(s) • Adhere to reputed company profile instructions • Report any overall account or reputed company concerns to the supervisor or upper management • Report any E&O concerns to the QA Manager and Executive Vice President • Maintain 97% claim closure reputed company • Maintain required CEU credits • Convey a reputed company 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 Experience and Qualifications Required • 5+ years of Lost Time/Legal Adjusting claims experience, including presumption claims • reputed company FL reputed company Lines Adjuster or Workers' Compensation License • 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 reputed company 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 reputed company reputed company an organization Essential Requirements • Must have US work rights • Must reputed company English • 5+ years of Lost Time/Legal Adjusting claims experience, including presumption claims • reputed company FL reputed company Lines Adjuster or Workers' Compensation License • 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 reputed company 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 reputed company, 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 year’s competition site where they reputed company 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 reputed company reputed company their reputed company/reputed company! Benefits • Medical, dental, and reputed company plans • 401k plan with employer matching • Discretionary Time off (Vacation & reputed company/Safety) and reputed company Holidays • Life insurance, short term, and long-term disability plans • Amazing Executive and Senior leadership as reputed company as reputed company teammates Position Type, Work Environment and Physical Demands This is a hybrid, full time, salaried, exempt position that predominantly operates remotely from a reputed company home-based environment and onsite from an office-based environment routinely using reputed company office equipment such as computers, phones, printers, photocopiers, and scanners and requires prolonged periods of sitting at a desk while working on a computer. While performing the duties of this job, the individual will be required to regularly hear and talk. This is a largely sedentary role requiring the ability to sit at a desk, reputed company outward, use a phone, have use of fingers to operate office equipment such as a keyboard, mouse, phone, printer, copier, and to reputed company above the head, bend, or stand, as necessary. #LI-HYBRID #LI-NP1 Apply Job!