Workers' Compensation Subrogation Claims Adjuster II

About Us 

At Davies, we get it... you are not just looking for a job, you are looking to build a life and a career. We believe in our people and realize that our success is a direct result of creating a learning atmosphere, leadership opportunities, and promoting from within. We believe that engaging in corporate social activities and working together as a team is a vital part of the Davies culture. 

With a multinational global team, Davies Group is a specialist professional services and technology firm working in partnership with leading insurance, highly regulated, and global businesses.  At Davies Group, we help clients to manage risk, operate core business processes, and to transform and grow. We deliver operations, consulting and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation, customer experience, human capital, transformation, and change management.  

As part of Davies Specialty Programs, PGCS specializes in Third Party Claims Administration for Workers’ Compensation and Liability claims. We pride ourselves on our friendly, team-orientated work environment. Our energetic team, supportive leaders, and can-do attitude enhance a sense of collaboration and belonging in our teammates. Our focus is on quality, professional, superior service. This service-driven philosophy, conveyed throughout the organization, means we operate with the customers’ best interests at heart, constantly reinforcing our mission – Service Beyond the Contract.

Are you looking for a company that is Dynamic and Innovative where the teammates are Connected and Succeed Together?  If so, Davies may just be the right choice for you.

Job Overview

USIS, Inc., part of Davies Specialty Programs, is looking for a WC Subrogation Claims Specialist II to be responsible for the effective handling of subrogation on workers’ compensation claims, aggressively pursuing recoveries in accordance with liability assessments and the Manfredo formula, pursuant to Company and State regulations.

Opportunity to work from home.

Responsibilities and Duties:

• Responsible for subrogation on workers’ compensation claims, aggressively pursuing recoveries in accordance with liability assessments and the Manfredo formula as well as being able to identify and notify responsible third parties of their potential exposures.
• Analyze claim exposure to determine the proper course of action and to appropriately review for subrogation and PIP recovery potential, evaluating evidence by interpreting facts within applicable legal framework to determine liability and lien value in accordance with state law, company and client policy and procedure. 
• Send Notice of Lien letters to appropriate parties.
• Ensure the proper use of the diary system to monitor claims.
• Follow state statutes in regard to resolving the lien. Utilize a formula, if applicable in the state, and include offsets against future benefits when available.
• Interact extensively with various parties involved in the claim process.
• Develop settlement/litigation/defense strategy by evaluating factual information to settle claims in a cost-effective manner, working with defense attorneys as necessary.
• Perform other duties as needed.

Experience and Qualifications

• A minimum of three years of claims-related subrogation experience with a consistent high level of performance and achievement.
• Active Florida All-Lines Adjuster License (5-20 or 6-20) or appropriate state licensure.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.   Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Knowledge, Skills and Abilities

• Experience in a claims handling environment experienced in handling subrogation on workers’ compensation and liability claims.
• Extensive knowledge of accepted industry standards and practices for subrogation. Ability to successfully negotiate the resolution of Workers’ Compensation liens.  
• Ability to effectively operate a personal computer and related claims and business software. 
• Must be motivated and able to work independently and effectively, within company guidelines.
• Ability to effectively operate a personal computer and related claims and business software. Technically competent with systems.
• Good communication skills, both oral and written; good customer service skills.   

Diversity and Inclusion 

Davies is committed to being a diverse and inclusive workplace. We welcome candidates of all genders, gender identity and expression, neurodiversity, sexual orientation, disability, physical appearance, body size, race, age, nationality, and belief (or lack thereof). 

Rewards and Recognition 

We embrace innovation and run an annual competition available for all colleagues to submit their ideas. The top finalists travel to the current year’s competition site where they pitch their ideas to our investors. The winner receives funding to bring their idea to life and the runners up receive a reward for their involvement. Some of our teammates have moved across into brand new positions to further develop their ideas/projects! 

Benefits 

• Medical, dental, and vision plans 
• 401k plan with employer matching 
• Paid Time Off, Sick Leave, and Paid Holidays 
• Life insurance, short term, and long-term disability plans 
• Amazing leadership and fabulous teammates 

Position Type, Work Environment and Physical Demands 

This is a home-based, full time, salaried, exempt position that predominantly operates remotely from a professional home-based office environment routinely using standard office equipment such as computers, phones, printers, photocopiers, and scanners and requires prolonged periods of sitting at a desk while working on a computer.  While performing the duties of this job, the individual will be required to regularly hear and talk.  This is a largely sedentary role requiring the ability to sit at a desk, reach outward, use a phone, have use of fingers to operate office equipment such as a keyboard, mouse, phone, printer, copier, and to reach above the head, bend, or stand as necessary. 

Application Information

Application deadline: September 20, 2024