Normandy Insurance Company
Remote Sr. Workers’ Compensation Adjuster
Adjuster Role
Due to our national expansion, we are seeking an experienced Workers’ Compensation Adjuster to join our team. This person will directly manage a claims inventory ranging 75-80 claims, working remotely and with some travel to our Boca Raton, Florida office, and other incidental travel as necessary, (10-15% travel). Salary to be determined commensurate with experience and other job-related factors.
What distinguishes Normandy in the Marketplace?
! at Normandy (NIC). Our differentiated approach to claims management is a refreshing departure from conventional workers’ compensation industry management. Our practices are designed to drive balanced, positive claim outcomes in both human (clinical), and financial terms, and promote the principle that parties participating in the system will do well, because of our doing good.
Responsibilities
Sr. Adjusters managing claims consistent with Normandy’s unique approaches while investigating, reviewing, analyzing, and evaluating claim information to make informed and appropriate benefit determinations.
The Work
- Work within a team environment that strengthens and supports Normandy’s unique culture, business model, and practices, to make merit-based and appropriate benefit determinations, including:
- Initial and ongoing claim investigation, coverage verification, statutory employment verification, accident compensability, medical causality/necessity, statutory & regulatory compliance, escalation practices, effective claim documentation & communication, etc.
- Manage all aspects of assigned individual claims, simple to complex, and in multiple states.
- Coordinate with NIC’s strategic partners and inter-departmental team members in the management of claims including, medical directors, legal counsel, nurse consultants, agents, underwriters, and others as necessary to gather information and make merit-based benefit determinations.
- · Develop and implement individual claim strategies designed to control adverse claim trending.
- Perform other duties as assigned.
- Effectively communicate with internal and external claim parties and resources.
- Effectively and appropriately resolve claims.
Education Qualifications
- High school diploma or equivalent required
- Batchelor’s degree preferred.
Experience Qualifications
- Current workers’ compensation claims adjusting experience, of which at least 3 years in the past 5 years have been dedicated to management of an assigned caseload of workers’ compensation claims.
- Technical and operational individual claims management experience (working knowledge of statute/regulation/relevant caselaw, medical necessity, causation)
- Multi-state workers’ compensation experience is preferred.
- Workers’ compensation licensure as necessary, additional industry certifications/designations a plus.
Skills And Abilities
- Proficiency in technical workers' compensation claim knowledge.
- Negotiation skills
- Excellent verbal and written communication skills
- Proficiency with desk management skills, organization, multiple priorities management.
- Ability to integrate claim investigation, medical, legal, and other factors to develop claim-specific strategies and identify financial exposure (reserving).
- Ability to review & analyze claims data & reports.
- Objectively assess claim facts to make benefit determinations.
- Moderate knowledge of Google business products, e.g., Gmail, google calendar, (Workspace).
Benefits
- 401(k)
- Dental Insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Professional development assistance
- Referral program
- Vision insurance
More About Normandy Insurance Company
Normandy Insurance Company stands at the forefront as a premier workers' compensation insurance carrier, dedicated to providing tailored solutions for businesses seeking comprehensive coverage. With a focus on excellence and reliability, we empower businesses to navigate the complex landscape of workers' compensation with confidence.
Job Type: Full-time
Work Location: Remote
