Senior Claims Specialist, Workers Compensation

This is an opportunity to join Ascot Group - one of the world’s preeminent specialty risk underwriting organizations.

Designed as a modern-era company operating through an ecosystem of interconnected global operating platforms, we are bound by a common mission and purpose: One Ascot. Our greatest strength is a talented team who flourish in a collaborative, inclusive, and entrepreneurial culture, steeped in underwriting excellence, integrity, and a passion to find a better way, The Ascot Way.

The Ascot Way guides our people and our organization. Our underwriting platforms collaborate to find creative ways to deploy our capital in a true cross-product and cross-platform approach. These platforms work as one, deploying our capital creatively through our unique Fusion Model: Client Centric, Risk Centric, Technology Centric.

Built to be resilient, Ascot maximizes client financial security while delivering bespoke products and world class service — both pre- and post-claims. Ascot exists to solve for our clients’ brightest tomorrow, through agility, collaboration, resilience, and discipline.

Position Overview:

The Senior Claims Specialist, Workers Compensation will investigate, evaluate and conclude lost time Worker’s Compensation claims of larger monetary exposure and/or complexity.  This can lead to a compensability decision and managing the claims until settled.   This position will report to a designated Claim Supervisor. 

Responsibilities:

• Responsible for investigating worker’s compensation claims cases from open to close and adhering to the claims processes and procedures with respect to payment, reporting, reserving, and auditing necessary for assigned caseload. 
• Responsible for contacting all parties involved in the claim, gathering and securing all necessary information to effectively evaluate the claim and outlining and recommending an action plan to manage the claim
• Provides excellent communication with policyholders, injured workers, medical providers, brokers, and attorneys throughout the course of the claim.
• Maintain a diary of all claims in a clear and concise manner by documenting all actions taken throughout the course of the claim.
• Ensures that assigned claims are properly documented, reserved and processed. 
• Make recommendations to Claims Manager as needed with respect to reserves and excess authority.
• Responsible for ensuring that payments are made in a timely manner.
• Review and investigate all bills for propriety, reasonableness and medical necessity. Work with the Claim Assistant to obtain additional documentation if needed from providers. 
• payment.
• Responsible for initiating settlement negotiations with the claimant, or claimant attorney, within their authority.
• Other duties as assigned

• Commitment to The Ascot Way: Embody The Ascot Way in their daily interaction with colleagues, fostering colleague engagement and development, collaboration, inclusivity, and individual accountability.

Requirements: 

• Bachelor’s Degree or equivalent experience.
• 5 years of workers’ compensation claim handling experience in Florida
• Resident Adjuster’s License in Florida
• Excellent verbal and written communication skills
• Strong interpersonal skills
• Medical terminology knowledge a plus
• Skilled at problem solving
• Ability to make effective decisions and escalating when needed.
• Experience with MS Office and any claim handling systems
• Strong collaborative skills and ability to thrive in a fast-paced, entrepreneurial environment.
• Strong organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously.
• Commitment to providing top quality service to all internal and external business partners.