Senior Claims Adjuster

Company

Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc.

Job Description

Business Title(s): Senior Workers’ Compensation Claims Adjuster 

Employment Type: Full-Time 

FLSA Status: Exempt 

Location: Field
 

Summary:  

We are looking for a highly capable Senior Workers’ Compensation Claims Adjuster to join our Claims team and work remotely from Nevada. The position reports to a manager based in California. This role will be adjudicating indemnity  workers’ compensation claims in the jurisdictions of CA, NV, and AZ and medical only workers’ compensation claims in the NV jurisdiction only, in order to contribute to providing superb results for our clients. 
 

This position is qualified as a field position
 

Essential  Responsibilities: 

• Working under limited technical direction and within broad limits and authority, adjudicate highly complex indemnity workers’ compensation claims on assignments reflecting potentially with significant impact on departmental results. 

• Solving difficult problems that requires an understanding of a broader set of issues. 

• Reporting to senior management and underwriters on claims trends and developments. 

• Investigating claims promptly and thoroughly  

• Analyzing claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage. 

• Investigating claims promptly and thoroughly, including interviewing all involved parties.  

• Managing claims in litigation  

• Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution.    

• Properly setting claim reserves.  

• Identifying, assigning, and coordinating the assignment and coordination of expertise resources to assist in case resolution.  

• Preparing reports for file documentation  

• Applying creative solutions which result in the best financial outcome.  

• Negotiating settlements  

• Processing mail and prioritizing workload.   

• Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.).  

• Having an appreciation and passion for strong claim management. 
   

Qualifications / Experience Required: 

• An advanced knowledge of workers’ compensation claims, as well as an exceptional customer service focus typically obtained through: 

• A minimum of five years’ experience adjudicating workers' compensation claims in one or more of the following jurisdictions: AZ, NV, and CA.  

• Bachelor’s degree from an accredited university required. Two or more insurance designations or four additional years of related experience adjudicating indemnity claims beyond the minimum experience required above may be substituted in lieu of a degree.  

• Either a CA Self-Insurance or possession of both the WCCA and WCCP designations, and AZ claims certification and a NV claims license are required or must be attained within 90 days of hire for employment to continue past that date.

• Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers’ ability to be profitable). 

• Must have excellent communication skills and the ability to build lasting relationships. 

• Ability to regularly exercise discretion and independent judgment with respect to matters of significance. This role primarily faces problems and issues that generalized and typically not complex, but require an understanding of a broader set of issues.  

• Strong claim negotiation skills a must. Ability to take proactive and pragmatic approach to negotiation. 

• Desire to work in a fast-paced environment. 

• Excellent evaluation and strategic skills required. 

• Must possess a strong customer focus. 

• Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines. 

• Ability to articulate the financial value of your work at multiple responsibility levels inside our clients’ business which may include CEO. 

• Demonstrates inner strength.  Has the courage to do the right thing and demonstrates it on a daily basis. 

• Exhibit natural and intellectual curiosity in order to consistently explore and consider all options and is not governed by conventional thinking. 

• Demonstrates an understanding of mechanisms available for resolving claims settlement disputes (e.g. arbitration and mediation) and when these are used. 

• Uses listening and questioning techniques to effectively gather information from insureds and claimants 

• Proficient in MS Office Suite and other business-related software. 

• Polished and professional written and verbal communication skills.  

• The ability to read and write English fluently is required.  

• Must demonstrate a desire for continued professional development through continuing education and self-development opportunities. 
   

The base salary range provided below is for hires in those geographic areas only and will be commensurate with candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, this position is eligible for an annual bonus based on company and individual performance as well as a generous benefits package. 

• Nevada Pay Range: $101,184  - $120,462

About Working in Claims at Argo Group 

Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful. 

Adjusters are empowered with broad authority and encouraged to develop creative, individualized solutions for each case.

We have a very flat organizational structure, enabling our employees have more interaction with our senior management team, especially when it relates to reviewing large losses. 
 

Our entire claims team works in a collaborative nature to expeditiously resolve claims. We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas. 
 

We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.