Claims Adjuster I (Workers' Comp) #2024-027

Responsible professional work managing Workers' Compensation claims against the City. Work is performed under the direction of the Risk Manager and evaluated through review of cases and by analysis of loss reports. Follows claims procedure for the City of Pompano Beach for medical and lost time cases. Collects data relating to claims and creates claims files; analyzes records and reports facts related to claims to Risk Manager. Settles or recommends settlements with claimants when authorized by the Risk Manager. Maintains extensive contact with injured workers, City officials, medical service providers, attorneys, insurance, and other public agencies. Frequently visits accident or job sites to gather information. Exercises considerable initiative and independent judgment in analyzing facts, arranging settlements and recommending resolutions of claims to the Risk Manager. Confers with City employees to determine City's liability. Obtains copies of contracts, medical, and payroll records and other pertinent evidence. Secures confidential investigations and other activities required for proper investigation of claims and to assist the defense of Workers' Compensation claims or lawsuits against the City. Review Workers' Compensation medical bills and adjusts pricing to comply with Florida Workers' Compensation Medical Fee Schedule. Enters data to record claims, maintains claims, diaries files, makes payments, and closes claim files. Works with local managed care provider to insure reporting of claims. Attends occasional safety meetings at the discretion of the Risk Manager to address areas of concern to City departments and employees. Maintains knowledge of OSHA regulations, or State of Florida reporting requirements. Establishes loss reserves and maintains loss statistics for all losses. Studies current literature to keep informed of new developments in compensation exposures caused by new legislation and/or legal decisions. Confers with attorneys, judges, doctors, and insurance carriers and may testify in court, or mediations regarding claims at the discretion of the Risk Manager. Performs related work as required.A #520 or #620 License (Licensed Adjuster) or Workers' Compensation Claims Adjuster license issued by the Department of Insurance of the State of Florida (a temporary license issued by the Department of Insurance will suffice if the permanent license is secured before its expiration). An Associate's degree or higher and at least three years' experience in Workers' Compensation adjusting or insurance related field. A comparable amount of training and experience may be substituted for the minimum qualifications. Possession of a valid, appropriate driver's license and an acceptable driving record. Knowledge of local, state and federal laws and regulations relating to area of assignment (Workers' Compensation). Knowledge of the FMLA Act of 1993, the Americans with Disabilities Act of 1990, the Heart and Lung Bill of 1993, pertinent case histories, making adjustments and settlements, and defending against claims/suits against the City. Ability to conduct claims investigations, to interview effectively, to observe and report accurate facts relating to incidents which may result in claims against the City. Ability to negotiate with claimants and resolve or recommend resolution of claims successfully. Ability to maintain and secure confidential information. Ability to empathize with employees about stressful and sensitive situations. Ability to multitask, organize, and prioritize in a busy environment. Ability to maintain regular and punctual attendance. Ability to effectively communicate and interact with other employees and the public. Ability to see, read, talk, hear, handle or feel objects and controls. Ability to use and operate various technological items. No significant standing, walking, moving, climbing, carrying, bending, kneeling, crawling, reaching, and handling, pushing, and pulling. Must be able to perform occasional light lifting up to 20 lbs. The noise level in this environment is usually quiet in an inside office setting, but may be loud when visiting facilities.

Work Days/Hours : Monday - Thursday, 7:00 a.m. - 6:00 p.m.

Job Status : ( X ) Full time ( ) Part time/temporary

Department/Number : Risk Management/5520 Pay Plan/Grade: 50/27
Position is open until filled.
The City of Pompano Beach welcomes everyone who would like to become a member of our team and who wants to "Do Good". The City does not discriminate on the basis of race, color, sex, age, national origin, disability, religion, genetic information, marital status, political affiliation, sexual orientation, gender identify, familial status, or other circumstances and characteristics protected by state or federal law. The City promotes diversity of culture, background, thought, and ideas. The City strives to make inclusion a part of everything we do and strives for a work environment that creates a sense of belonging for everyone. Employment Type: Full time