Workers' Compensation Lost Time Adjuster

Workers' Compensation Lost Time Adjuster Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States Reporting To: Shirley Smith-Chavis Compensation: $52,000 - $55,000 / year Description Our Story Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. Davies Claims North America is looking for an experienced Lost Time Adjuster to conduct thorough investigations of assigned Workers’ Compensation claims. Reporting to the Workers’ Compensation Supervisor, you will adjust claims for assigned Davies Claims North America TPA clients, provide benefits, and initiate state filings timely while exercising discretion and independent judgment. To be successful in this role, you need to be proactive and independent while taking initiative with consistent follow through, demonstrate a high level of attention to detail, and possess superb problem solving skills. You must have at least 1 to 3 years of experience handling Workers’ Compensation claims as well as exhibit working knowledge of Workers’ Compensation Statutes and Rules and their application. Additionally, you will need to display an exceptional capability to multi-task and prioritize with excellent organization and documentation skills in a fast-paced, dynamic work environment.

Key Responsibilities

Adjust claims for assigned Davies Claims North America TPA clients Investigate claims by completing 24-hour contact with employee, employer, physician(s), and witnesses Evaluate claim detail, Florida Statute, and case law to determine compensability and total value of claim Display capability of setting and adjusting reserve amounts accordingly Initiate accurate indemnity payments in a timely manner and maintain diary for ongoing payments Ensure timely and proper completion of all required State filings Handle EDI filings and rejections in conjunction with EDI adjuster Monitor medical treatment in conjunction with the assigned Nurse Case Manager Review, document and approve medical bills for payment within three days of receipt Authorize appropriate medical services as outlined per Florida Statute 440.13 Maintain regular telephone contact with injured employees Determine whether vocational rehabilitation services are needed for an employee to return to work Coordinate light duty availability and reasonable accommodations with medical providers and employers Maintain adequate reserves for life of claim utilizing reserve worksheets, ODG Guidelines, Workers’ Computation software, and Davies Claims North America reserving philosophy Attend client meetings as necessary, and maintain regular telephone contact to ensure client satisfaction Evaluate cases and negotiate settlements when appropriate, protecting Medicare’s interests Review claims for possible red flags Identify and pursue subrogation, contribution, indemnification, or other opportunities to compel responsible third parties to bear their share of the settlement burden Make timely notice to the excess carrier in all cases while meeting reporting criteria and keeping the carrier updated on claim status Request reimbursement at least quarterly and follow up for timely receipt from excess carrier(s) Adhere to client profile instructions Report any overall account or client concerns to the supervisor or upper management Report any E&O concerns to the QA Manager and EVP Attend claims meetings at client locations, client visits, seminars for obtaining CEU credits Interact with Managers, Training Coordinator, Supervisors, Adjusters, Nurse Case Managers, Team Assistants, Employers, Injured Workers, Medical Providers, Ancillary Providers, State Employees, Insurance Carriers, Excess Carriers, and Brokers as needed Convey positive attitude and team spirit for optimum provision of services to customers Exhibit company values of We are Dynamic, We are Innovative, We are Connected, and We Succeed Together Perform other duties as assigned Skills, knowledge & expertise 1 to 3 years handling Workers’ Compensation claims Possession of an active Florida All Lines Adjuster or Workers’ Compensation license Maintain required CEU credits for licensure Maintain working knowledge of Workers’ Compensation Statutes and Rules, and their application Maintain diary and workflow requirements Maintain 97% claim closure ratio Proactive, independent, and takes initiative with consistent follow through Superb communication skills, verbal and written, conducted in a timely manner Superior time management skills with capability of working with and meeting deadlines Exceptional capability to multi-task and prioritize with excellent organization and documentation skills in a fast-paced, dynamic work environment Excellent team player with interpersonal skills High level attention to detail and problem-solving skills Capable of working collaboratively and independently with minimal supervision Exhibit discretion with sensitive and confidential information Display a comfort level working with key people at all levels within an organization Equal Employment Opportunity & Legal Notices

Benefits

At Davies North America, we are dedicated to supporting the well‑being and future of our qualifying employees. Our comprehensive benefits package includes: Medical, dental, and vision plans to support your health and that of your family A 401(k) plan with employer matching Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees Paid holidays Life insurance and short‑term and long‑term disability coverage Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee’s primary work location. Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements. Diversity and Inclusion Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

Compensation

Transparency: The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices. Background Check & Fair Chance Compliance Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair‑chance hiring requirements. Massachusetts Notice It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at [email protected] Apply To This Job