Claims Adjuster-Worker's Compensation

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 investigate, evaluate, and settle insurance claims in accordance with company policies and regulatory requirements. The adjuster works closely with policyholders, legal representatives, and other stakeholders to ensure fair and timely resolution of claims. Benefits of Broward County Employment High-Deductible Health Plan – bi-weekly premiums: Single $10.90 / Family $80.79 Includes a County Funded Health Savings Account of up to $2,000 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) General Description 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. Scope of Work Contact the injured employee, employer, and medical provider (or claimant and witnesses for liability claims) to document the claim. Conduct field investigations, face‑to‑face statements, and recorded interviews to understand the nature of the claim. Calculate and process disability benefits, medical benefits, and impairment ratings, and enter all payments. Initiate timely electronic filings to the Division of Workers' Compensation for disabilities lasting more than 8 days. Authorise/coordinate medical treatment, including walk‑in facilities and specialists, and update claim status. Process outgoing letters and notices for injured employees and medical providers. Denies or processes non‑work‑related injury claims with timely electronic filing. Prepare accident reports and coordinate gathering of formal evidence (photographs, diagrams, measurements). Negotiate claim settlements with county officials and claimants or their legal teams; attend mediations when needed. Provide advice on fraud, subrogation, underwriting/safety risk, and communicate with counsel. Analyze complex information from police reports, videos, and other sources to determine liability. Make decisions for approval of medical treatments, property restoration, and settlement amounts. Attend meetings with other divisions and Human Resources to discuss complex claims. Perform related work as assigned. Work Environment Physical Demands : Sedentary work with walking or standing some of the time; exert up to 10 pounds of force on a regular basis. No unavoidable hazards identified. Education and Experience Requirements Two (2) years of higher‑level education in workers' compensation and/or general liability claims adjusting and insurance/risk management, or substitution of one year of relevant experience for each year of required education. Four (4) years in adjusting workers' compensation and/or bodily injury/property damage liability claims, or closely related experience. Special Certifications and Licenses Florida All‑Lines Adjuster's License (Type 6‑20 or 7‑20) from the State of Florida Division of Insurance Agent and Agency Services. Valid Florida Class E Driver's License. Preferences 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. At least 2 years of experience in recorded statements. At least 2 years of experience responding to Conditional Payment demands from the Center for Medicare Services. At least 2 years of experience negotiating workers' compensation lien recoveries. Competencies Financial Acumen : Interprets and applies key financial indicators to make better business decisions. Determines and estimates the main direct and indirect costs; makes generally appropriate decisions regarding expenditures. Studies financial and quantitative information; uses data to improve performance. Decision Quality : Makes good and timely decisions that keep the organization moving forward. Knows when to act independently and when to elevate issues. Integrates various inputs, decision criteria, and trade‑offs to make effective decisions. Optimizes Work Processes : Knows the most effective and efficient processes to get things done, with a focus on continuous improvement. Uses metrics and benchmarks to monitor accuracy and quality. Ensures Accountability : Holds self and others accountable to meet commitments. Accepts responsibility for own work, both successes and failures. Drives Results : Consistently achieves results, even under tough circumstances. Holds self to high standards of performance; sets challenging goals; pursues initiatives to successful completion. Manages Conflict : Handles conflict situations effectively, with a minimum of noise. Seeks out a variety of opinions and options; maintains an open mind. Communicates Effectively : Develops and delivers multi‑mode communications that convey a clear understanding of the unique needs of different audiences. Situational Adaptability : Adapts approach and demeanor in real time to match shifting demands of different situations. County Core Values Collaborates : Building partnerships and working collaboratively with others to meet shared objectives. Customer focus : Building strong customer relationships and delivering customer‑centric solutions. Instills trust : Gaining the confidence and trust of others through honesty, integrity, and authenticity. Values differences : Recognizing the value that different perspectives and cultures bring to an organization. Equal Employment Opportunity Broward County is an Equal Opportunity Employer committed to inclusion. We provide equal opportunity and reasonable accommodations to qualified persons with disabilities. If you require assistance due to a disability, please contact the Professional Standards Section in advance at View phone number on click.appcast.io or email View email address on click.appcast.io to make an accommodation request. Emergency Management Responsibilities During emergency conditions, all County employees are automatically considered emergency service workers and may be called to work in the event of a disaster or other emergency situation and are expected to perform emergency service duties as assigned. County-wide Employee Responsibilities All Broward County employees must serve the public and fellow employees with honesty and integrity in full accord with the letter and spirit of Broward County's Employee Code of Ethics, gift, and conflict of interest policies. Employees must establish and maintain effective working relationships with the general public, co‑workers, elected and appointed officials and members of diverse cultural and linguistic backgrounds, regardless of race, color, religion, sex, national origin, age, disability, marital status, political affiliation, familial status, sexual orientation, pregnancy, or gender identity and expression. #J-18808-Ljbffr