This role manages claims of increasing complexity based on level, including moderate to complex losses, litigated matters, and catastrophic exposures. The adjuster develops and executes strategic action plans to ensure claims are resolved appropriately, efficiently, and in compliance with jurisdictional requirements.

Key Responsibilities

• Own the full lifecycle of Workers’ Compensation claims, from initial investigation through resolution
• Determine compensability and coverage with confidence and accuracy
• Conduct detailed investigations, including interviews and evidence gathering
• Analyze medical, legal, and employment documentation to guide decision-making
• Manage EDI reporting and ensure CMS Section 111 compliance
• Develop and execute strategic claim plans for complex and litigated files
• Partner with defense counsel to drive effective litigation strategies and control costs
• Negotiate settlements with claimants and attorneys to achieve optimal outcomes
• Handle catastrophic and high-severity claims with care and precision
• Leverage preferred vendors and cost-containment tools effectively
• Deliver clear, insightful reporting to clients and excess carriers
• Maintain strong client relationships through responsive, professional communication
• Stay current on jurisdictional requirements, trends, and best practices
• Support team development through mentorship and knowledge sharing

Skills, Knowledge & Expertise

• 3+ years of Workers’ Compensation claims handling experience
• Experience with lost time claims, compensability analysis, and claim strategy preferred
• An active FL license is required (5-20 or 6-20)
• Direct experience handling Workers’ Compensation claims (level-dependent)
• Knowledge of Workers’ Compensation laws and jurisdictional requirements
• Understanding of medical terminology and its impact on claim exposure
• Strong investigation, analysis, and decision-making skills
• Effective negotiation and communication abilities
• Ability to manage multiple priorities in a fast-paced environment
• Proficiency with claims systems and related technology
• Professionalism in handling sensitive or confidential information

Benefits

• Medical, dental, and vision plans to support your health and that of your family
• A 401(k) plan with employer matching
• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees
• Paid holidays
• Life insurance and short-term and long-term disability coverage

Job Data by YubHub.

This role works at the intersection of business processes and technology. The Systems Analyst will learn our insurance platforms and workflows, help translate business needs into system requirements, support solution design and testing, troubleshoot application and data issues, and work closely with business and engineering teams to deliver reliable solutions.

This is a hands-on role suited to someone who enjoys understanding how systems work, how data moves between them, and how to investigate when something goes wrong. The successful candidate does not need to be a solution architect or software engineer. We are looking for strong analytical and technical aptitude, curiosity, attention to detail, and a willingness to learn.

The position will primarily support second-shift operations from 2:00 PM to 10:00 PM, providing important overlap with both daytime delivery teams and evening production operations. For next projects, the person would have a standard 9 - 18.

Key Responsibilities

Business & Systems Analysis

• Develop an understanding of insurance workflows, including underwriting, policy lifecycle, billing, claims, servicing, and downstream data processing.
• Work with business stakeholders, product teams, and engineers to translate business needs into clear system requirements, workflows, data requirements, and acceptance criteria.
• Analyze existing applications, integrations, and processes to understand system behavior, dependencies, and potential areas for improvement.
• Support the implementation of new insurance products and enhancements to existing platforms.
• Document system requirements, business rules, interfaces, data mappings, dependencies, and solution decisions.
• Help maintain traceability between requirements, system changes, testing, and delivered functionality.

Solution Design & Delivery

• Work with business and engineering teams to help develop practical system solutions within our insurance and low-code platforms.
• Review proposed system changes to understand potential impacts to existing applications, integrations, data, and operational processes.
• Review implemented solutions to confirm that they meet documented business and system requirements.
• Support engineering teams by answering requirements questions and helping resolve functional or system-design questions during development.
• Participate in functional testing, solution validation, deployment readiness, and post-production verification.
• Identify opportunities to simplify workflows, improve supportability, or address recurring system issues.

Data, Integrations & APIs

• Analyze data flows between insurance platforms and internal and external systems.
• Investigate data-quality issues, field-mapping errors, and failures within ETL and data-export processes.
• Assist with defining and validating system interfaces, data mappings, transformation requirements, and API behavior.
• Use SQL and other tools to investigate data issues and identify where discrepancies originate.
• Troubleshoot integration failures and partner with engineering teams to resolve identified issues.
• Support integrations with external insurance partners, including MGAs, TPAs, reinsurers, and distribution partners.

Production Support & Root-Cause Analysis

• Support in the analysis of production incidents across supported insurance platforms:
• Investigate application and production issues such as:
• Integration and API failures
• Batch-processing failures
• Concurrent-update conflicts
• Data discrepancies
• Performance issues
• System and workflow errors
• Gather logs, system information, and supporting data to help identify the cause of production issues.
• Perform root-cause analysis with support from engineering and other technical teams when needed.
• Coordinate with engineering teams on issue resolution and validate fixes once implemented.
• Identify recurring issues and recommend improvements to systems, processes, monitoring, or documentation.
• Follow appropriate controls and procedures when working with production environments.

Performance & System Reliability

• Help document non-functional requirements such as performance, availability, scalability, resilience, and operational supportability.
• Support the planning and execution of performance and stress testing.
• Review test results and assist engineering teams in identifying performance or scalability concerns.
• Monitor application behavior and help identify opportunities to improve system reliability and operational visibility.

Automation & Operational Tooling

• Use scripting and lightweight automation to make troubleshooting, validation, and production support more efficient.
• Develop or maintain practical scripts and utilities for activities such as:
• Data-quality checks
• Compliance validation
• Log analysis
• Uptime and availability reporting
• Repetitive operational tasks
• Look for opportunities to reduce manual effort and improve the consistency of recurring support activities.

Skills, Knowledge & Expertise

• 3+ years of experience as a Systems Analyst, Business Systems Analyst, Technical Business Analyst, Application Support Analyst, or in a similar technical role.
• Strong analytical and problem-solving skills with a desire to understand how interconnected systems work.
• Working knowledge of SQL and experience using data to investigate application or business issues.
• Basic understanding of APIs, system integrations, or data interfaces.
• Familiarity with ETL processes, data pipelines, data mappings, or similar data concepts.
• Experience troubleshooting application, system, integration, or data issues.
• Ability to communicate effectively with both technical and business stakeholders.
• Strong attention to detail and willingness to learn unfamiliar systems, technologies, and business processes.
• Ability to work with production systems using appropriate care, controls, and operational discipline.
• Ability to work second shift, 2:00 PM to 10:00 PM.

Preferred Qualifications

The following experience is helpful but not required:

• Experience working within the insurance industry or with policy, billing, claims, underwriting, or servicing systems.
• Experience with low-code application platforms.
• Experience with insurance platforms.
• Experience using Python or another scripting language for lightweight automation or data analysis.
• Experience with MongoDB or another document-oriented database.
• Experience with ETL or data integration technologies such as Fivetran.
• Experience with centralized logging or monitoring tools such as Graylog, Splunk, or ELK.
• Experience investigating APIs or system integrations.
• Exposure to application performance, load, or stress testing.
• Experience supporting business-critical applications in a production environment.

Job Data by YubHub.

Key Responsibilities

Team Leadership & Development

• Supervise and support a team of liability claims adjusters.
• Provide technical guidance and mentorship to adjusters handling bodily injury, casualty, and liability claims.
• Conduct performance reviews, coaching sessions, and ongoing training to support staff development.
• Assist with staffing, onboarding, and workload distribution across the team.

Claims Oversight

• Monitor claims handling activities to ensure compliance with company guidelines and client service standards.
• Review high-exposure or complex liability claims and provide guidance on claim strategy and resolution.
• Approve claim settlements within assigned authority levels.
• Ensure appropriate reserve settings and claim documentation.

Client & Stakeholder Collaboration

• Serve as a point of contact for clients regarding claim performance and operational questions.
• Participate in client meetings and provide updates regarding claim trends, outcomes, and performance metrics.
• Collaborate with legal counsel, vendors, and internal teams to support effective claim resolution.

Operational Performance

• Monitor team performance metrics including claim cycle time, quality assurance results, and service level agreements.
• Identify opportunities for operational improvements and implement best practices.
• Support leadership with reporting and operational updates.

Skills, Knowledge & Expertise

• 5+ years of claims handling experience in liability, casualty, or bodily injury claims
• Active Florida license (5-20 or 6-20)
• TPA experience highly preferred
• Experience with Sovereign Immunity highly preferred
• Experience with excess reporting highly preferred
• Prior supervisory or leadership experience preferred
• Strong knowledge of liability claims handling practices and litigation management
• Excellent leadership, communication, and decision-making skills

Benefits

• Medical, dental, and vision plans
• 401(k) plan with employer matching
• Time-off policies, including Discretionary Time Off (DTO) and Paid Time Off (PTO)
• Paid holidays
• Life insurance and short-term and long-term disability coverage

Job Data by YubHub.

Key Responsibilities

• Configure and customize Fenergo Fen-X components, including workflows, rules, forms, data models, integrations, and user interfaces.
• Translate business requirements and functional specifications into configurable Fenergo solutions.
• Design and maintain onboarding, KYC, AML, Client Lifecycle Management (CLM), and regulatory compliance processes.
• Perform solution configuration using Fenergo best practices and standards.
• Support integration activities between Fenergo and upstream/downstream systems.
• Develop and execute unit, system, and user acceptance testing activities.
• Troubleshoot configuration issues and provide timely resolution.
• Collaborate with Solution Architects and Technical Leads on design decisions and implementation strategies.
• Participate in release planning, deployment activities, and post-production support.
• Create and maintain configuration documentation, process flows, and operational procedures.
• Support continuous improvement initiatives and platform enhancements.

Skills, Knowledge & Expertise

• Fenergo Certified Professional (current certification strongly preferred).
• Proven experience configuring Fenergo Fen-X solutions in financial services environments.
• Strong understanding of Client Lifecycle Management (CLM), KYC, AML, Customer Due Diligence (CDD), and regulatory onboarding processes.
• Experience configuring workflows, business rules, forms, data structures, and case management functionality within Fenergo.
• Knowledge of REST APIs and integration concepts within enterprise application environments.
• Experience working in Agile delivery environments.
• Strong analytical, problem-solving, and stakeholder management skills.
• Excellent verbal and written communication skills.

Preferred Qualifications

• Experience delivering Fenergo implementations for global banking, capital markets, wealth management, or asset management clients.
• Exposure to cloud-based and SaaS deployment models.
• Understanding of regulatory frameworks including FATCA, CRS, MiFID II, EMIR, Dodd-Frank, and related compliance requirements.
• Experience with data migration and system integration projects.
• Familiarity with DevOps, CI/CD pipelines, and release management practices.

Education & Certifications

• Bachelor's degree in Computer Science, Information Technology, Finance, Business, or a related discipline.
• Fenergo Certified Professional (Mandatory).
• Additional AML / FCC certifications highly desirable.
• Relevant industry certifications in compliance, financial services, or project delivery are advantageous.

Key Competencies

• Fenergo Fen-X Configuration
• Client Lifecycle Management (CLM)
• KYC / AML Processes
• Business Rules & Workflow Design
• Regulatory Compliance
• Stakeholder Management
• Testing & Quality Assurance
• Agile Delivery
• Financial Services Domain Knowledge

Job Data by YubHub.

The position focuses primarily on Employment Practices Liability (EPL) and Professional Liability claims, with additional exposure to Businessowners Policy (BOP) and General Liability (GL) claims within program structures.

This role serves as a key subject matter expert for coverage issues, advising internal teams and carriers on complex liability matters and ensuring claims are handled in accordance with applicable laws, regulations, and company guidelines.

Key Responsibilities

Coverage Analysis

• Review and interpret EPL, Professional Liability (E&O), BOP, and GL policies, endorsements, and applicable statutes.
• Analyze coverage issues including wrongful termination, discrimination, harassment, wage and hour exposures, professional negligence, and bodily injury/property damage triggers under GL.
• Draft and issue coverage position letters, including reservations of rights and denial letters, ensuring clarity and compliance with legal and regulatory standards.
• Evaluate and provide input on coverage forms and policy language as needed by carriers.

Claims Investigation & Strategy

• Oversee and conduct complex claims investigations involving employment-related allegations, professional services exposures, and occasional GL-related losses.
• Analyze liability and damages in matters involving back pay, front pay, emotional distress, punitive damages, and economic loss.
• Develop and implement strategic approaches for claim resolution, including oversight of litigation when necessary.
• Provide carriers with independent evaluations of claims based on investigation, experience, and input from outside experts and counsel.

Negotiation & Settlement

• Evaluate exposure and make settlement recommendations, including setting and managing reserves within carrier guidelines.
• Negotiate settlements within authority limits, balancing legal risk, financial exposure, and business objectives.
• Participate in mediations and settlement conferences as required.

Regulatory Compliance & Documentation

• Ensure all claims handling complies with Department of Insurance regulations and internal protocols.
• Maintain accurate and thorough documentation in the claims management system, including coverage analyses and strategic recommendations.

Collaboration & Communication

• Serve as a trusted advisor to internal teams and carriers on EPL, Professional Liability, and GL-related coverage issues.
• Act as the primary coverage and strategy resource in interactions with external counsel, policyholders, and other stakeholders.

Skills, Knowledge & Expertise

Required (one of the following):

• Juris Doctor (JD) with active bar membership in good standing, or
• 7–10+ years of senior-level experience handling EPL, Professional Liability, GL, or similar complex liability claims.

Also required:

• Active adjuster licenses and willingness to obtain and maintain additional licenses, as needed.
• Demonstrated expertise in insurance coverage analysis and policy interpretation.
• Experience issuing or advising on coverage positions, including RORs and denials.
• Strong understanding of liability, damages, and litigation strategy.
• Experience managing high-frequency EPL programs and familiarity with panel counsel management and billing guidelines in EPL matters.
• Exceptional analytical, negotiation, and communication skills.
• Ability to manage multiple high-severity, complex claims independently.
• Proficiency with claims management systems and related tools.

Preferred:

• Background in EPL, Professional Liability, or mixed program business including BOP/GL exposure.
• Experience working closely with coverage counsel or in-house legal teams.
• Prior involvement in program business or specialty lines environments.

Benefits

• Medical, dental, and vision plans to support your health and that of your family
• A 401(k) plan with employer matching
• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees
• Paid holidays
• Life insurance and short-term and long-term disability coverage

Job Data by YubHub.