Claims Associate

2 weeks ago


Rockwood, United States Argonaut Management Services, Inc Full time

Argo Group is a leader in specialty insurance with a vibrant culture built on respect, equality, wellness and opportunity. We‘re an innovative organization that‘s small enough to be agile and big enough to make a difference in our industry.

Our flexible workplace is continuously evolving to ensure all employees feel:

  • Comfortable bringing their whole selves to work.
  • Confident that they will be treated respectfully.
  • Recognized for their performance and provided with equal opportunities to succeed.

At Argo, skill meets opportunity. If you‘re wired to raise your hand and ask, ‘Where can I help?‘, you‘ll thrive with us.

A Brief Overview

We are looking for a highly capable Workers‘ Compensation Claims Adjuster to join our team and work from our Rockwood office or another of our US Offices. This role will adjudicate indemnity workers‘ compensation claims of complexity for our customers in various states.

The role will work hybrid (no less than three days per week on-site) at one of our following offices: Rockwood, PA, San Antonio, TX, Richmond, VA or Chicago, IL .

This is a Claims Adjuster role however well qualified candidates at the trainee level, as well as the Sr. Claims Adjuster level, will also be considered.

If hired as a Claims Adjuster Trainee, you must be in the office 5 days a week until your training is completed.

Responsibilities:

  • Under close/moderate supervision and guidance, analyzing claim forms, policies and endorsements, client instructions and other records to determine whether the loss falls within the policy coverage
  • Investigating the claim - this requires calling the claimant, insured employer, healthcare provider, and witnesses to determine compensability issues, status of claims (medical only or indemnity), and subrogation potential.
  • Denying any claims that are not covered or do not meet compensability criteria and successfully defending that decision if challenged.
  • Actively managing medical only claims to ensure only medical bills appropriate to the claim are paid on a timely basis.
  • Managing a diary, completing tasks and applying creative solutions 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.
  • Negotiating settlements
  • Preparing reports for file documentation
  • Processing mail and prioritizing workload.
  • Responsible for telephone calls from various parties (insured, claimant, medical facilities, etc.).
  • Having an appreciation and passion for strong claim management.

Qualifications:

  • Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers‘ ability to be profitable).
  • A knowledge of adjudicating workers‘ compensation claims through
    • Bachelor‘s degree from an accredited university preferred (but not required).
    • Various years of experience based on the level of the role.
  • Ability to prioritize workload and handle multiple tasks.
  • Ability to articulate the financial value of your work at multiple responsibility levels inside our clients‘ business which may include the CEO.
  • Exhibit a natural curiosity.
  • Desire to work in a fast-paced environment.
  • Excellent evaluation and strategic skills required.
  • Strong claim negotiation skills a must.
  • Must possess a strong customer focus.
  • Must work independently and demonstrate the ability to exercise sound judgment.
  • Proficient in MS Office Suite and other business-related software.
  • Polished and professional written and verbal communication skills.
  • Ability to travel, sometimes overnight, approximately 10% of the time.
  • The ability to read and write English fluently is required. The ability to read and write Spanish fluently is strongly preferred but not required.
  • Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.

PLEASE NOTE: At this time, Argo Group will not sponsor an applicant for employment authorization for this position.

If you have a disability under the Americans with Disabilities Act or a similar law and you wish to discuss potential accommodations related to applying for employment at Argo Group, please contact our Benefits Department at .

To all recruitment agencies: Unless you have been requested to work on this position, or other positions with Argo Group, please do not forward any resumes to Argo Group employees. Argo Group is not responsible for any fees related to unsolicited resumes.

Argo Group International Holdings, Ltd. is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The company is a wholly owned subsidiary of Brookfield Reinsurance Ltd. Argo and its insurance subsidiaries are rated A-‘ by Standard and Poor‘s. Argo‘s insurance subsidiaries are rated A-‘ by A.M. Best. More information about Argo is available at www.argogroup.com.

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

Our Benefits

Developing our employees professionally and personally strengthens our organization.
Argo Group offers an attractive Total Rewards package that includes:

  • A culture that recognizes performance and empowers employees to excel, offering competitive compensation and merit driven profit sharing.

  • Flexible workplace policies that support employee well-being include compressed hours, flex-time, job-sharing, remote work, sabbatical leave, and holiday hours.

  • Comprehensive health, wellness, and financial planning options that employees can tailor to meet their personal and family needs. In addition to traditional health and wellness plans, benefits include dental, disability, life insurance, medical, and vision insurance, matching 401(k) retirement savings, generous paid time off (21 days of PTO, 11 paid company holidays, 3 floating holidays and a paid voluntary day), paid caregiver and parental leave, paid bereavement, jury duty/court appearances, and military (up to 14 days) leave, employee assistance program (EAP), and an array of voluntary benefits.

  • Argo Academy, a digital and instructor-led platform that offers continuous learning and professional development -Trainingmagazine lists Argo among the Training ‘Top 125‘ Companies. Argo encourages career mobility and continuing education to pursue and maintain professional and industry designations, in addition to traditional university and higher education programs.

  • An inclusive culture that develops and sponsors diverse teams, encourages cross-functional engagement and collaboration, builds community through employee resource groups (ERGs), and provides an environment that welcomes ongoing dialogue, creative innovation, professional and personal development.

  • Active community outreach and volunteer programs.

  • A generous Employee Referral program that results in approximately 25% of all new hires annually.

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