Workers' Compensation Claims Examiner

Argo Group and Farm Family are specialty property and casualty insurance brands whose underwriting companies are wholly owned subsidiaries of Brookfield Wealth Solutions, a leading provider of wealth and insurance solutions. Argo and Farm Family partner with agents and brokers to help businesses stay in business, delivering collaborative insurance solutions for niche markets.

Job Description

PURPOSE OF THE JOB:

The Examiner are responsible for the oversight of Workers Compensation claims being handled by 3rd party TPAs. This will include the investigation, evaluation, negotiation and settlement of claims. This includes analyzing coverage, and ensure reserves are appropriate in accordance with the company guidelines. Examiners are required to understand and comply with Insurance Regulations, Statutes, and case law accordingly. The Examiners work closely with TPAs, other departments, vendors and defense counsel as needed throughout the claim process. Depending on the level of complexity, claim values can range from a nominal amount to millions of dollars.

ESSENTIAL FUNCTIONS:

• P&C – Oversight of Multi state Workers Compensation Claims

• Handles Large Loss Reporting and Reinsurance Notifications.

• Reviews, interprets, summarizes and communicates concerns or opportunities related to the TPA claim handling.

• Oversight of files in excess of a million dollars or complex coverage issues.

• Provides day-to-day assistance to the management team as it relates to technical handling questions, research and file strategy.

• Completes targeted audits and other special projects.

QUALIFICATIONS:

• 8 years’ claims experience in handling Workers Compensation Claims.

• Maintain Continuing Education (CE) requirements for state licensing when appropriate.

PREFERENCES:

• Bachelor’s degree in a related field or the equivalent years’ work experience.

JOB FAMILY:

Claims Representative

Sr. Claims Representative

Claims Specialist

Sr. Claims Specialist

Claims Examiner
 

Note: Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

Salary range is $ 69,462.00 - 140,862.00 USD Annual