Medical Only Workers' Compensation Adjuster [C]

Argo Group International Holdings, Inc . and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. ("BWS"), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions.

Job Description

A Brief Overview

We are looking for a highly capable Medical Only Claims Adjuster to help us on a temporary estimated three-month assignment and work from anywhere in the United States. If this role is filled so the individual can work five days a week in any of the following offices, we can consider this a temp-to-hire assignment : Albany, Chicago, Los Angeles, New York City, Omaha, Richmond (VA),Rockwood (PA), San Antonio, or Springfield (MO). The medical only claims adjuster responsibilities include determining whether coverage exists in our system for the insured, denying claims ineligible for benefits, and thoroughly investigating the claim by interviewing the injured worker, employer, and medical provider. As this is a temporary assignment, only government mandated benefits will be provided.

How You Will Make an Impact :

• Under close supervision and guidance, works within narrowly defined limits with an impact on departmental results - this requires calling the claimant, insured employer, healthcare provider, and witnesses to determine compensability issues and subrogation potential.
• Resolving issues that are generalized and typically not immediately evident, but typically not complex and within immediate job area.
• Denying any claims that are not covered or do not meet compensability criteria and successfully defending that decision if challenged.
• Actively manage medical only claims to ensure only medical bills appropriate to the claim are paid on a timely basis.
• Managing a diary and completing tasks to ensure that cases are resolved timely and at the right financial outcome.
• Properly setting claim reserves.
• Identifying and directing the assignment and coordination of expertise resources to assist in case resolution.
• Preparing reports for file documentation
• Processing mail and prioritizing workload.
• Responsible for telephone calls from various parties (insured, claimant, etc.).
• Having an appreciation and passion for strong claim management.

What We Need :

Six years' experience adjudicating medical only claims or related billing, customer service, or general insurance / medical experience. At least one year of experience in the insurance or healthcare industry (preferably in a commercial claim department) is required, as is familiarity with medical terminology.

The base salary range provided below is for hires in those geographic areas only and will be commensurate with candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, all employees are eligible for an annual bonus based on company and individual performance as well as a generous benefits package.

Los Angeles and New York City Pay Range :

$34.57 - $40.34 per hour

Albany and Chicago Pay Range :

$31.68 - $36.97 per hour

About Working in Claims at Argo Group

PLEASE NOTE :

Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.

If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at 210-321-8400.

Notice to Recruitment Agencies :

Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited. BWS and / or its affiliates will not be responsible for any fees associated with unsolicited submissions.

We are an Equal Opportunity Employer. We do not discriminate on the basis of age, ancestry, color, gender, gender expression, gender identity, genetic information, marital status, national origin or citizenship (including language use restrictions), denial of family and medical care leave, disability (mental and physical) , including HIV and AIDS, medical condition (including cancer and genetic characteristics), race, religious creed (including religious dress and grooming practices), sex (including pregnancy, child birth, breastfeeding, and medical conditions related to pregnancy, child birth or breastfeeding), sexual orientation, military or veteran status, or other status protected by laws or regulations in the locations where we operate. We do not tolerate discrimination or harassment based on any of these characteristics.

The collection of your personal information is subject to our HR Privacy Notice

Benefits and Compensation

We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program-including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.