Claims Adjuster

Overview

The Broward County Board of County Commissioners is seeking qualified candidates for Claims Adjuster in the Risk Management Division. We are seeking a detail-oriented and customer-focused Worker s Compensation Claims Adjuster to join our team. In this role, you will investigate, evaluate, and settle insurance claims in accordance with company policies and regulatory requirements. You will work closely with policyholders, legal representatives, and other stakeholders to ensure fair and timely resolution of claims.

• High-Deductible Health Plan – bi-weekly premiums:
  Single $10.90 / Family $80.79
• Includes a County Funded Health Savings Account of up to $2000 Annually
• Consumer Driven Health Plan – Bi-weekly Premiums:
  Single $82.58 / Family $286.79
• Florida Retirement System (FRS) – Pension or Investment Plan
• 457 Deferred Compensation employee match
• Eleven (11) paid holidays each year
• Vacation (Paid Time Off) = 2 weeks per year
• Up to 40 hours of Job Basis Leave for eligible positions
• Tuition Reimbursement (Up to 2K annually)

Performs advanced specialized technical work in the investigation and adjustment of public liability and/or Workers  Compensation claims. Works under general supervision, independently developing work methods and sequences. The Workers Compensation Adjuster calculates/processes disability benefits for impairment ratings of 1% or more when issuing benefits to avoid penalties. Sets up medical claims to document/update current work status and treatment. Monitors/obtains medical records and work status to ensure timely calculation and payment of indemnity and impairment ratings, complete State EDI mandated reporting within regulated time frames to avoid penalties.

Processes employee-received notices of outstanding medical bills to resolve non-payment issues. Reviews/corrects reporting by Center of Medicare/Medicaid Services (CMS) for accuracy.

Requires two (2) years equivalent of higher-level education in workers  compensation and/or general liability claims adjusting and insurance/risk management. (One year of relevant experience may be substituted for each year of required education.) Requires four (4) years in adjusting workers  compensation and/or bodily injury/property damage liability claims or closely related experience.

Possession/retention of a Florida All-Lines Adjuster s License (Type 6-20 or 7-20) from the State of Florida Division of Insurance Agent and Agency Services. Must possess and maintain a valid Florida Class E Driver s License for duration of appointment.

• Associates in Claims (AIC) Certificate.
• Certified Insurance Counselors (CIC) or Chartered Property Casualty Underwriter (CPCU).
• Certification in Workers  Compensation (CWC).
• Accredited Claims Adjuster (ACA).
• Bachelor s degree or higher in related field
• 2 or more years of experience in recorded statements.
• 2 or more years of experience responding to Conditional Payment demands from the Center for Medicare Services.
• 2 or more years of experience negotiating workers  compensation lien recoveries.

The functions below represent the majority of time spent in this class. Management may assign additional functions related to the type of work of the job as necessary. For Workers  Compensation claims the adjuster will contact the injured employee, employer, and medical provider to document the claim. For Liability claims the adjuster will contact the claimant, the division and any witnesses.

The Workers Compensation Adjuster calculates/processes disability benefits for impairment ratings of 1% or more when issuing benefits to avoid penalties. Sets up medical claims to document/update current work status and treatment. Monitors/obtains medical records and work status to ensure timely calculation and payment of indemnity and impairment ratings, complete State EDI mandated reporting within regulated time frames to avoid penalties.

Reviews/corrects reporting by CMS for accuracy.

Contacts injured employee, employer, and medical provider to document claim. Conducts field investigations, face-to-face…