Responsibilities:

• Adjust claims for assigned Davies Claims North America TPA clients
• Conduct thorough investigations, including 24-hour contact with employees, employers, physicians, and witnesses
• Evaluate claim details, Florida Statutes, and case law to determine compensability and total claim value
• Set and adjust reserve amounts accordingly
• Initiate accurate indemnity payments and maintain diaries for ongoing payments
• Ensure timely and proper completion of all required State filings
• Handle EDI filings and rejections with the EDI adjuster
• Monitor medical treatment with the assigned Nurse Case Manager
• Review, document, and approve medical bills for payment within three days of receipt
• Authorize appropriate medical services as outlined in Florida Statute 440.13
• Maintain regular telephone contact with injured employees
• Determine whether vocational rehabilitation services are needed for an employee to return to work

Requirements:

• At least 1-3 years of experience handling Workers' Compensation claims
• Working knowledge of Workers' Compensation Statutes and Rules and their application
• Proactive and independent with excellent problem-solving skills, attention to detail, and organization abilities

This is a full-time hybrid position requiring onsite attendance three days a week at our client's office in Palm Beach County, Florida, with the remaining two days worked remotely.

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