Davies North America

Global insurance professional services and tech

Workers' Compensation Medical Only Adjuster

Claims AdjudicationUpdated on Nov 13

Full-time$45.5k - $50k /yr

About the Job

Requirements

At least 3 years of Workers’ Compensation claims handling experience.
Must hold an active and valid Florida license (5-20 or 6-20).
Independently handle Workers’ Compensation claims of moderate complexity.
Apply sound judgment in negotiations, reserving, and file direction.
Maintain compliance with jurisdictional requirements, client service expectations, and internal standards.

Responsibilities

Manage Workers’ Compensation claims from intake through closure, including medical-only claim types.
Determine compensability and benefit eligibility.
Establish and adjust reserves based on claim exposure.
Conduct investigations, including interviews and documentation review.
Develop and execute claim strategies.
Identify opportunities for early resolution.
Monitor treatment plans and coordinate return-to-work efforts.
Administer indemnity benefits in compliance with jurisdictional requirements.
Coordinate with defense counsel on litigated claims.
Support hearings, mediations, and settlements.
Provide timely updates to clients and stakeholders.
Ensure compliance with state regulations and internal standards.
Evaluate exposure and manage treatment progression, indemnity administration, and return-to-work coordination.
Handle some litigated matters.

Desired Qualifications

Experience with medical-only Workers’ Compensation claim portfolios is preferred.

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.

What's in Store
We’re seeking a Workers’ Compensation Medical Only Claims Adjuster who brings strong technical expertise, sound judgment, and a proactive approach to managing indemnity and medical-only claims. You must be licensed in FL to handle workers' compensation claims.

This role manages Workers’ Compensation claims from intake through resolution and support medical-onlyclaim types. The adjuster investigates, evaluates, and manages claims in accordance with company guidelines, client expectations, and jurisdictional requirements.

Claim Ownership & Adjudication

Manage Workers’ Compensation claims from intake through closure
Determine compensability and benefit eligibility
Establish and adjust reserves based on claim exposure

Investigation & Case Management

Conduct investigations, including interviews and documentation review
Develop and execute claim strategies
Identify opportunities for early resolution

Medical & Indemnity Management

Monitor treatment plans and coordinate return-to-work efforts
Administer indemnity benefits in compliance with jurisdictional requirements

Litigation Management

Coordinate with defense counsel on litigated claims
Support hearings, mediations, and settlements
Client Communication & Compliance
Provide timely updates to clients and stakeholders
Ensure compliance with all state regulations and internal standards

3+ years of Workers’ Compensation claims handling experience
Must have an active and valid license in FL (5-20 or 6-20)
Experience with medical-only Workers’ Compensation claim portfolios preferred
Independently handles Workers’ Compensation claims of moderate complexity
Determines compensability, conducts investigations, evaluates exposure, and establishes appropriate reserves
Manages claim strategy, treatment progression, indemnity administration, and return-to-work coordination
Handles some litigated matters and applies sound judgment in negotiations, reserving, and file direction
Maintains compliance with jurisdictional requirements, client service expectations, and internal standards

About the Company

Davies North America

Global insurance professional services and tech

Davies North America is a global professional services and technology company that began in the UK as an insurance claims manager. It now provides technology, consulting, and legal solutions to clients in regulated industries, including insurance, through managed services, outsourcing, and advisory offerings. The company grows by acquiring other businesses to expand its geographic reach and service capabilities. Its goal is to become a global leader in professional services and technology for regulated industries, particularly in markets like the US, Canada, and Bermuda.

Company size: 5,001-10,000
Company stage: Debt Financing
Total funding: $363M
Headquarters: London, United Kingdom
Founded: 1968

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