WC Adjuster (Lifetime Medical Only)

About Us

At Davies, we get it... you are not just looking for a job, you are looking to build a life and a career. We believe in our people and realize that our success is a direct result of creating a learning atmosphere, leadership opportunities, and promoting from within. We believe that engaging in corporate social activities and working together as a team is a vital part of the Davies culture.

With a multinational global team, Davies Group is a specialist professional services and technology firm working in partnership with leading insurance, highly regulated, and global businesses. At Davies Group, we help clients to manage risk, operate core business processes, and to transform and grow. We deliver operations, consulting and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation, customer experience, human capital, transformation, and change management. 

Davies Claims Solutions operates within the rapidly expanding US segment of the Casualty & Transportation business. We provide end to end solutions for property, liability, workers’ compensation, auto claims, and more. We offer a full range of desk-led technical claims handling, adjusting, appraisals, and supply chain services.

Are you looking for a company that is Dynamic and Innovative where the employees are Connected and Succeed Together?  If so, Davies may just be the right choice for you.

Job Overview 

Davies Claims Solutions is looking for an experienced Workers’ Compensation Claims Adjuster who will be responsible for investigating and analyzing claims, determining coverage, and negotiating settlements with claimants. Reporting to the Claims Supervisor you will determine the extent of insurance coverage and compensability on each filed workers’ compensation claim.  

To be successful in this role, you need to possess high level attention to detail and problem-solving skills and demonstrate the exceptional capability to multi-task and prioritize with excellent organization and documentation skills in a fast-paced, dynamic work environment. You must have at least 3 to 5 years of experience handling Workers’ Compensation claims and a college degree or equivalent business experience. Additionally, you must have superb communication skills, both verbal and written, conducted in a timely manner, and exhibit discretion with sensitive and confidential information. This role is a full-time remote position.

Responsibilities and Duties

• Determine the extent of insurance coverage and compensability on each filed claim
• Investigate claims, including interviewing employees, employers, and witnesses
• Obtain necessary records, including but not limited to, hospital records, police reports, and physical records
• Utilize appropriate vendor for medical bill review
• Present thorough and accurate reports to clients and excess carriers on claims investigations and situations   
• Negotiate settlements for resolutions with claimants and their attorneys 
• Attend meetings, conferences, workshops, or training sessions as requested
• Review written materials to maintain current knowledge on principles, practices, and new developments in assigned work areas
• Respond to client questions and comments in a courteous and timely manner
• Exhibit company values of We are Dynamic, We are Innovative, We are Connected, and We Succeed Together
• Perform other duties as assigned

Experience and Qualifications

Required

• 3-5 years of experience handling Workers’ Compensation claims
• College degree or equivalent business experience
• Hold an active Adjuster license 
• Maintain CEU credits for required state licensing
• Exhibit capability of understanding and following oral and/or written policies, procedures, and instructions
• Maintain extensive knowledge of medical and legal terminology with a thorough understanding of legal principles 
• Demonstrate ability to conduct investigations in multi-party situation
• Ability to prepare and present accurate and reliable reports containing finding and recommendations
• Possess thorough knowledge of current principles and practices associated with claims investigations, adjustment, and related practices
• Operation of a computer using standard or customized software applications appropriate