Sr. Workers Comp Claims Adjuster (Must have Florida Adjuster Licence )

Handle a caseload of approximately 130 pending claims encompassing all levels of complexity. Requires establishing facts of loss, coverage analysis, investigation, compensability/liability/negligence determination, coordination of medical care, litigation management, damage assessment, settlement negotiations, identifying potential fraud & appropriate use of authorized vendors. Includes timely & appropriate reserve analysis & report completion. Ability to attend conferences, client meetings, mentor other adjusters & assist management as requested. File handling must be within state statutes, Client Claims Handling Guidelines & NARS Best Practices. Essential Duties & Responsibilities: Identify, analyze and confirm coverage. Customer Service/Contact: Contact appropriate parties & providers to determine liability, compensability, negligence & subrogation potential. Contact appropriate parties to obtain any needed information & explain benefits as appropriate. Continue contact during life of file as appropriate. Answer phones, check voice mail regularly & return calls as needed. Assist with training/mentoring of Claims Adjusters. Assist management when required with projects or leadership as requested. Handle the various duties/responsibilities of Unit Manager as delegated in their absence. Subro: Refer all files identified with subrogation potential to the subrogation department. Investigation: Verify facts of loss & pertinent claims facts such as employment, wages, or damages & establish disability with treating physicians as appropriate. Identify cases for settlement. Evaluate claims & request authority no later than 30 days prior to mediation date & negotiate settlement. Litigation Management: Develop & direct litigation plan with defense attorney, utilizing all defenses & tools to bring file to closure. Ensure all filings & state mandated forms are completed timely. Litigated files must be diaried effectively based on current activity, no greater than every 60 days. Review claim files involving active litigation monthly at minimum, document responses to filings, development of defenses, depositions, & timely referral to defense counsel. Reporting Requirements: Report all serious injuries/liability issues & potential large loss claims to client and/or reinsurer based upon the criteria provided by the client. Technical skills: Advance level of interpersonal skills to handle sensitive/confidential situations & information. Requires advanced ability to negotiate claims & direct litigation. Must have negotiation and litigation skills for significant work with attorneys. Requires advanced ability to work independently, an advanced level of organization, time management skills & advanced level written & verbal communication skills. Abilities: Requires long periods of sitting, working indoors in environmentally controlled conditions, lifting of files/boxes up to 20#, use of keyboard/mouse & exposure to computer screens, travel as assigned.

Company DescriptionNorth American Risk Services (NARS) is a premier third-party claims administrator that is dedicated to producing the best possible results for our clients. "Founded in 1996, NARS handles claims for insurers, brokerages, managing general agencies, reinsurers, liquidation bureaus, self-insured funds and entities."

For more career opportunities and to learn more about NARS, please visit www.narisk.com.

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