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 DescriptionA Brief OverviewWe 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 :

A working knowledge of medical only claims typically achieved through :

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.

Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.