Workers' Compensation Lost Time Adjuster

MDD Forensic Accountants

Lost Time Adjuster conducting investigations on Workers’ Compensation claims for Davies North America. Requires 1-3 years of relevant experience and state licensing.

Posted 7/13/2026full-timeLakewood Ranch • Florida • 🇺🇸 United StatesMid-LevelSenior💰 $55,000 - $58,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in handling Workers’ Compensation claims, including knowledge of Florida Statutes and the ability to evaluate claims, negotiate settlements, and maintain compliance with regulatory requirements. Exhibits strong communication, time management, and organizational skills to effectively manage claims and client relationships.

Highest-signal resume keywords

Workers’ Compensation Claims HandlingFlorida All Lines Adjuster LicenseClaim Evaluation and NegotiationRegulatory ComplianceSuperb Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claim InvestigationIndemnity Payments ProcessingEDI Filings ManagementMedical Bill Review and ApprovalReserve ManagementVocational Rehabilitation AssessmentSubrogation and Contribution IdentificationClaim Closure Ratio MaintenanceDocumentation and ReportingWorkflow Management

Soft Skills

Proactive InitiativeTime ManagementMulti-taskingInterpersonal SkillsAttention to Detail

Tools & Technologies

Workers’ Computation SoftwareODG GuidelinesDiary Management Systems

Certifications & Qualifications

Florida All Lines Adjuster LicenseCEU Credits Maintenance

Industry Keywords

Workers’ Compensation StatutesClaims AdjustingClient SatisfactionMedical Services AuthorizationExcess Carrier Communication

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

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

Benefits

Comp & perks

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