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American National · 20 hours ago

Senior Workers’ Compensation Claims Adjuster

US VA - Richmond

Full-time

Onsite

Senior Level

5+ years exp

American National, a subsidiary of Brookfield Wealth Solutions, is seeking a highly capable Senior Workers’ Compensation Claims Adjuster to join their Claims team. The role involves adjudicating complex workers’ compensation claims and providing exceptional customer service to clients, with a focus on the mining industry.

Auto InsuranceFinancial ServicesHealth CareHealth InsuranceInsuranceLife Insurance

No H1B

Responsibilities

Working under limited technical direction and within broad limits and authority, adjudicate highly complex indemnity and federal black lung workers’ compensation claims on assignments reflecting potentially with significant impact on departmental results. In addition, adjudicate medical-only claims reported by the account as well. Providing laser-focused customer service to our clients by providing superior claims outcomes and developing meaningful and long-lasting connections with our insured and brokers

Solving difficult problems that requires an understanding of a broader set of issues

Reporting to senior management, loss control, and underwriters on claims trends and developments

Identifying loss drivers and claims trends to reduce claims frequency and severity through data analysis and improved claim management

Investigating claims promptly and thoroughly

Analysing claims forms, policies and endorsements, client instructions, and other records to determine whether the loss falls within the policy coverage

Investigating claims promptly and thoroughly, including interviewing all involved parties

Managing claims in litigation

Managing diary timely and complete tasks to ensure that cases move to the best financial outcome and timely resolution

Creating and reviewing reserves in line with market and Argo's reserving policy

Identifying, assigning, and coordinating the assignment and coordination of expertise resources to assist in case resolution

Preparing reports for file documentation

Applying creative solutions which result in the best financial outcome

Settling straightforward claims in line with authority limits and adheres to organizational referral procedures

Negotiating in a timely and effective manner to provide cost effective solutions for the company and its customers within own limits using a range of negotiation styles

Processing mail and prioritizing workload

Completing telephone calls and written correspondence to/from various parties (insured, claimant, etc.)

Having an appreciation and passion for strong claim management

Qualification

Workers' compensation claimsClaims negotiationClaims analysisBusiness acumenLicensing in KYMS Office SuiteCommunication skillsTime managementCustomer focusProblem-solvingFlexibility

Required

Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers' ability to be profitable)

An advanced knowledge of workers' compensation claims through: A minimum of five years' experience adjudicating workers' compensation claims in any of the following jurisdictions: CO, KS, KY, MD, MI, MO, MT, PA, UT, and/or WV

Bachelor's degree from an accredited university required. Two or more insurance designations or four additional years of related experience adjudicating workers' compensation claims beyond the minimum experience required above may be substituted in lieu of a degree

Must be licensed in KY or have ability to quickly obtain a license to adjudicate first party claims

Must have excellent communication skills and the ability to build lasting relationships

Ability to regularly exercise discretion and independent judgment with respect to matters of significance. This role primarily faces problems and issues that are difficult that requires an understanding of a broader set of issues

Strong claim negotiation skills a must. Ability to take proactive and pragmatic approach to negotiation

A strong focus on execution in getting things done right. Proven ability to consistently produce and deliver expected results to all stakeholders by: Finding a way to achieve success through adversity

Being solution (not problem) focused

Thinking with a global mindset first

Client focus – the ability to effectively determine specific client needs and to provide value added solutions

Successful traits (flexibility, ability to thrive in change, being resourceful on your own) necessary to work in a fast-paced environment that is evolving constantly

Excellent evaluation and strategic skills required

Must possess a strong customer focus

Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines

Ability to articulate the financial value of your work at multiple responsibility levels inside our clients' business which may include CEO

Demonstrates inner strength. Has the courage to do the right thing and demonstrates it on a daily basis

Exhibit natural and intellectual curiosity in order to consistently explore and consider all options and is not governed by conventional thinking

Demonstrates an understanding of mechanisms available for resolving claims settlement disputes (e.g. arbitration and mediation) and when these are used

Uses listening and questioning techniques to effectively gather information from insureds and claimants

Proficient in MS Office Suite and other business-related software

Polished and professional written and verbal communication skills

The ability to read and write English fluently is required

Must demonstrate a desire for continued professional development through continuing education and self-development opportunities