MDD Forensic Accountants

Manager

• Provide exceptional internal and external Customer Support in a phone support role
• Assist insureds, their representatives, and healthcare providers by supporting the processing of highly individualized claim inquiries
• Professionally and appropriately respond and/or forward inquiries by reviewing the established standards and guidelines
• Ensure smooth transition of claim while monitoring aging of assigned tasks meeting turnaround time standards
• Identify and respond to needs of inbound and outbound callers utilizing active listening skills; professionally and appropriately
• Prepare claims for Claim Manager review and adjudication
• Process and document the daily administrative activities associated with claim notifications including pending, open, and closed claims, utilizing multiple tabs/screens working within a centralized work que
• Responsible for input of accurate and detailed data and notes consistently meeting established standards
• May perform additional duties and/or assist with special projects as required
• File management and organization
• Maintain electronic file management and organization of incoming and outgoing mail including imaging, indexing, classification of documents, file management, etc.
• Critically review all documentation for completeness, credibility, consistency, and order
• Ability to recognize possible process deficiencies and suggest viable solutions
• Meet or exceed all established minimum expectations/metrics and goals for the position
• Meet or exceed standards for productivity and quality as established for the role
• Appropriately process all confidential information abiding by HIPAA privacy laws
• Ensure smooth transition of inquiry to appropriate department if/when necessary

Claim Manager Assistant I

Claims Specialist

• Conduct prompt, accurate investigations of liability claims, interview all relevant parties to obtain loss events facts and to establish liability; handle claims files to final resolutions.
• Analyze claim exposures, determine the proper courses of action, and appropriately settle claims, evaluating evidence by interpreting facts within applicable legal frameworks to determine liability and claim values.
• Interact extensively with various parties involved in the claim process.
• Develop settlement/litigation/defense strategies by evaluating factual information to settle claims in a cost-effective manner; work with defense attorneys and the client per account handling guidelines.
• Document and communicate all claim activity timely and effectively which supports the outcome of claim files, in accordance with established procedures; develop and maintain a progressive plan of action.
• Utilize a system diary system effectively and appropriately to keep claims files current.
• Examine and address claim files reserves for accuracy.
• Prepare for and assume lead roles in collaboration with defense counsel during mediations, arbitrations and trials.
• Formulate problem-solving platforms to plan, organize and negotiate claim resolutions, timely and with maximum cost efficiency, for service to the client.

Senior Liability Claims Adjuster

• Investigate and evaluate claims to determine coverage, compensability, and liability
• Conduct thorough investigations, including interviews with claimants, employers, and witnesses
• Obtain and review relevant documentation (e.g., medical records, police reports, employment records)
• Develop and implement strategic action plans for claim resolution
• Prepare and present clear, accurate, and timely reports to clients and carriers
• Manage EDI reporting and CMS/Section 111 compliance requirements
• Negotiate settlements with claimants and legal representatives to achieve fair resolutions
• Oversee litigation activities, ensuring effective cost control and alignment with account requirements
• Utilize approved vendor partners to support claims handling activities
• Handle complex claims, including catastrophic losses and sensitive issues
• Respond promptly and professionally to client inquiries and communications
• Maintain compliance with all licensing and regulatory requirements
• Stay current with industry trends, legal updates, and best practices through ongoing training
• Support team development by mentoring and sharing expertise with colleagues, as needed
• Perform other duties as assigned

Senior Workers' Compensation Claims Adjuster

Attorney

• You will work as part of the London Healthcare & Sports team and will both handle your own matters under supervision and support other senior lawyers to progress each file from receipt of papers from the insurer client to resolution of the claim.
• Delivery of agreed performance targets and quality standards - the Assistant Lawyer will be expected to record 7 chargeable hours per day.
• Following correct file handling procedures, including file opening processes, preparation of client care letters and complying with client SLAs.
• Reviewing an initial file of papers, preparing appropriate chronologies and forming initial views on breach of duty, causation and quantum with preparation of reports to clients.
• Obtaining and carrying out appropriate client instructions, including researching suitable experts and obtaining liability reports, liaising with both insured and insurer clients and updating strategy recommendations as appropriate.
• Maintaining a strict overview of reserves on all files and arranging billing at regular intervals. Appropriate reserve recommendations made to clients with regular reserve reviews completed.
• Drafting a variety of documents including Court documents, instructions to experts and counsel, advices to clients and without prejudice settlement correspondence.
• Handling the file efficiently on a day to day basis, to include fielding telephone calls and general queries, liaising with the parties involved (including insurers, insureds, experts and witnesses), ensuring adherence to Court Guidelines and obtaining CRU/NHS Charges certificates.
• Dealing with a Court timetable, including complying with disclosure, facilitating witness statement preparation and exchange of expert reports etc.
• Suitably organising the matter-associated paperwork through use of Egress/Bundledocs.
• Using and maintaining the internal case management system (Tracker) to keep the digital file current.
• Carrying out legal research tasks.

Solicitor, NQ - 5PQE, Healthcare Team

• All of Band 1 and 2 work with peer review but no supervision required.
• Undertake advocacy, drafting and advisory work; including but not limited to: settling complex / high value pleadings, complex interlocutory hearings, fast track and multi track trials, CCMCs, JSMs, sanctions (including private prosecution) and recoveries.
• At least one area of established niche practice, with room to develop and add others.
• Maintain and/or develop high level technical ability across all Keoghs core practice areas.
• Able to command higher hourly rate and premium brief fees;
• Sought after by partners / technical directors and senior decision makers at clients for advice and strategic analysis.
• Management of sub-team, or assisting in management of main team.
• Deliver advocacy and litigation training / updates for fee earners.
• Direct supervision and mentoring of Band One and Two Advocates.
• Undertake and proactively develop client facing, product development tasks as required.
• Be proactive in the development and marketing of the in house advocacy team.

Solicitor Advocate / Barrister, Band 3

• Determine eligibility of LTC claims to individualized policy
• Interpret LTC policy coverage using claims guidelines and policy language to assess eligibility.
• Evaluate provider qualifications and covered services.
• Accurately input and maintain complete data, documentation, and notes in the claims administrative system.
• Monitor the aging of assigned tasks to ensure compliance with established turnaround time standards.
• Educates claimants and their representatives on policy coverage and claim processes
• Serve as the point of contact for claimants and/or their representatives, ensuring a positive and supportive experience.
• Contribute to process improvement initiatives by helping develop enhanced customer service strategies.
• Stay current on relevant state/territory regulations, industry trends, and emerging issues.
• Investigate and analyze medical evidence to determine whether policy benefit qualifier(s) are met.
• Consult with claimants’ physicians and/or providers as needed to gather supporting medical information.
• Conduct telephonic evaluations to monitor claimants’ progress and assess changes in care needs over time.
• Identify and escalate claims requiring special handling, including proposed denials, potential fraud, or coordination of benefits with other payers.
• Clinical Review Responsibilities
• Review and summarize medical records to support claim evaluations.
• Assess complex medical claims upon request from non-clinical team members, providing clinical insight and guidance.
• Review claim files and complete Chronically Ill Certifications in accordance with policy requirements and regulatory standards.

Claim Manager, Clinician

• Review and assess workers' compensation claim files to identify viable subrogation potential
• Conduct detailed investigations to determine third-party liability through accident reports, witness statements, medical records, and other evidence
• Maintain an active pending of approximately 200+ claim files, ensuring timely and accurate file documentation, diary maintenance, email and correspondence review, and task execution
• Collaborate with clients to provide updates, recommendations, and recovery strategies in accordance with specific authority levels and settlement guidelines
• Negotiate settlements with third parties, attorneys, and carriers, while protecting client interests and ensuring compliance with applicable laws and regulations
• Work both independently and as part of a collaborative team to achieve recovery targets and meet organizational goals
• Maintain proficiency with internal systems and tracking tools to manage case progress and reporting
• Stay current on state-specific workers’ compensation and subrogation statutes, especially within Florida and any other assigned jurisdictions
• Provide guidance and support to junior team members or contribute to cross-functional projects as needed
• Support company values of *We are Dynamic, We are Innovative, We are Connected, and We Succeed Together*
• Perform other duties as assigned

Subrogation Claims Specialist

• Adjust bodily injury, personal injury, and wrongdoing claims in a timely and professional manner
• Perform all duties outlined in the Property Damage Adjuster role
• Review new claim assignments within 24 hours and develop a clear plan of action
• Establish contact with insureds and claimants within 24 hours of assignment
• Conduct thorough investigations including:
• Gathering evidence and documentation
• Obtaining recorded statements from claimants, insureds, and witnesses
• Reviewing internal client investigation reports when applicable
• Evaluate damages and determine need for appraisers or field adjusters
• Review estimates and supporting documentation for accuracy and appropriateness
• Set reserves and maintain accurate claim evaluations
• Manage claim workflow and system reminders; ensure progress within 72 hours of assigned tasks
• Coordinate with defense counsel and monitor litigation activity when applicable
• Handle claim denials in accordance with client and regulatory guidelines
• Request payment authorization in alignment with client and Davies procedures
• Maintain consistent, professional communication with clients, claimants, and partners
• Ensure accurate and timely documentation of all claim activity in the claim system
• Manage Medicare reporting and compliance where applicable
• Run ISO ClaimSearch and evaluate potential fraud indicators
• Identify and report claims to excess carriers when thresholds are met
• Respond to reservation of rights and excess carrier communications as needed
• Maintain compliance with state regulations (including PIP/No-Fault laws where applicable)
• Monitor claim progress and maintain a target 95% claim closure ratio
• Participate in continuing education to maintain adjuster licensure
• Support team members and assist leadership with additional duties as assigned

Bodily Injury Claims Adjuster

• Determine, evaluate, investigate, negotiate and resolve quota share and single insurer property claims
• Verify coverage under the applicable Commercial Property insurance policy
• Coordinate with field adjusters and experts for inspections or further investigation
• Review supporting documentation submitted for the claims and properly note the details of the review within the file
• Analyze damage estimates and repair costs as well as review vendor invoices for accuracy
• Identify potential issues such as fraud, duplicate claims, or policy exclusions
• Communicate with policyholders, adjusters, contractors, and other stakeholders regularly to ensure constant claim progression and keep all involved parties updated
• Prepare written status and large loss reports for clients, including Reservation of Rights and Coverage Position Letters
• Handle appeals or disputes related to claim decisions
• Attend mediations and settlement conferences as necessary
• Direct and monitor defense counsel to settle litigated claims
• Provide monetary authority and strategy to counsel to ensure client’s money and claims are protected
• Present and explain claim overviews to business partners on a monthly basis
• Participate in audits and quality control reviews
• Stay updated on industry trends, policy changes, and best practices

Commercial Property Claims Adjuster

Therapist

• Responsible for the direction and management of return-to-work efforts for injured employees
• Work is conducted outside the office; travel is required by driving own vehicle to appointments
• Maintain and submit timely and accurate productivity documentation
• Liaise with employers to understand work environments, find opportunities for light duty placement availability, encourage RTW advantages
• Document the claim file via written formal reports, system entry, email and facsimile
• Document outcomes of vocational services and placement opportunities
• Use applicable third-party guidelines and medical restrictions to assess potential placement
• Evaluate, implement and monitor the effectiveness of transitional work plans including time projections
• Use professional expertise in identifying tasks to be compiled to create transitional duties
• Coordinate site visits with assigned agencies to train, motivate and create transitional work opportunities
• Handle personal visits with the injured employee to determine status and needs, including return-to-work options and goals
• Maintain regular contact with clients following placement, as per program guidelines; contacts involved individuals regarding progress on each case and makes suggestions as needed for changing rehabilitation plans
• Use professional knowledge of medical management and its components related to Workers’ Compensation
• Work independently, with minimal supervision or direction, following Davies North America policies and procedures
• Maintain patient privacy by ensuring that all medical records, case-specific information and provider-specific information are kept in a confidential manner, in accordance with state and federal laws and regulations
• Adhere to medical and legal regulations and accreditation standards for written communication
• Act as a resource to all departments within Davies
• To perform the driving/travel duties of the job in a productive and efficient manner, you must maintain an active Driver’s License, current auto insurance, and a good Motor Vehicle Report
• Perform other duties as needed

Return To Work Specialist – Occupational Therapist, Physical Therapist, Vocational Case Manager

Chief Technology Officer

• Define and maintain the North American technology product strategy, ensuring full alignment to the Group-wide claims product strategy and ClaimPilot transformation roadmap.
• Ensure NA platform decisions support the Group’s commitment to ClaimPilot as the global unified claims platform, replacing legacy and siloed systems across business lines.
• Embed “build once, use many” product principles, ensuring reusable components and shared capabilities reflect the Group product architecture.
• Own multiyear NA product roadmaps covering platforms, tools, analytics, workflow, and client interfaces, ensuring alignment with Group product governance and prioritisation.
• Translate business and technology strategy into sequenced, outcome-based delivery increments for engineering teams.
• Oversee the lifecycle of technology products from discovery through adoption, scale, maturity, and retirement.
• Lead initiatives to consolidate legacy claims systems into the modern ClaimPilot platform.
• Support the displacement of third party claims systems and tools where Davies IP is available, consistent with Group platform strategy.
• Work with Group Product to ensure NA requirements inform global platform evolution and shared component enhancement.
• Operate within Group product governance, OKR frameworks, and decision making structures to ensure transparency, control, and prioritised value delivery.
• Provide visibility of NA roadmap progress, migration performance, capability adoption, delivery velocity, and risk.
• Ensure compliance with Group architecture, cyber, security, and AI governance standards for all NA product initiatives.
• Partner with business unit leaders, operations, engineering, data, and architecture teams to translate NA business needs into coherent product strategies and delivery priorities.
• Represent North America in Group product forums, contributing market-specific insights, user needs, and value cases into the global roadmap.
• Communicate product strategy, roadmap progress, and migration outcomes across executive and operational leadership.
• Drive adoption of ClaimPilot and associated shared services across NA internal teams and clients.
• Define and track key product usage, migration, operational efficiency, and experience metrics to evidence value delivered.
• Partner with business to realise benefits related to reduced duplication, cost savings, improved claim cycle times, and enhanced client outcomes.

Head of Technology Products

Paralegal

• - Update case management system with file allocations, diary records, court dates, directions, applications and orders as well as general activity, ensuring accurate recording of activity to allow progress tracking.
• - Drafting of routine court documents. Examples may include AOS, Notice of Change, Court Orders, Witness Summons and precedent based applications.
• - Liaising with Courts, Counsel, Opponents, Experts, Witnesses, Insureds and brokers to progress the case. Examples of tasks include requesting and providing updates; requests for extensions to comply with directions; dealing with GP, hospital, OH and Personnel mandates; booking Counsel for hearings and conferences; and appointments with experts.
• - Follow up on outstanding instructions, documents and other actions to ensure that responses are received within required timescales.
• - Make payment requests using the appropriate payment request process for the client and chase to ensure payments are received and dispatched within required deadlines.
• - Diarising and updating CRU.
• - To ensure compliance with the SRA Standards & Regulations.
• - Undertaking additional ad hoc duties to support the File Handlers and the team.
• - Complete initial steps in recovery of our Client’s outlay and collate the outcome.
• - Undertake minor investigations on liability and quantum so as to provide File Handlers with basic information to be able to progress the claims.
• - Undertake administration duties on files, such tasks may include completion of MI; drafting write off forms, requesting final bills and dealing with billing queries; and file closure/transfer activities.

Entry Level Paralegal

• Investigate first party physical damage and third party liability claims to determine coverage, liability, and damages
• Review accident reports, witness statements, repair estimates, and related claim materials
• Conduct interviews with claimants, insureds, witnesses, and other involved parties
• Analyze policy provisions and coverage details to determine claim applicability
• Complete damages investigations including repair estimates, loss of use, diminished value, etc
• Issue payments in accordance with coverage, liability, and damages investigation, company policies, and client service standards
• Identify subrogation, or other risk transfer opportunities, and refer the file to the subrogation unit
• Manage assigned claims from initial report through resolution
• Establish and maintain appropriate claim reserves based on claim exposure
• Establish and maintain appropriate plan of action and file diary
• Evaluate damages including bodily injury, liability exposure, and property damage
• Negotiate settlements with claimants, attorneys, and other involved parties
• Process form letters
• Maintain regular communication with clients, insureds, claimants, and other involved parties
• Provide updates regarding claim status, strategy, and resolution progress
• Deliver high-quality customer service
• Maintain accurate and detailed claim documentation within the claims management system
• Ensure claim handling complies with company guidelines, regulatory requirements, and client service standards
• Identify potential fraud indicators and escalate concerns when appropriate

Liability Associate, Claims Adjuster

Administrative Assistant

• Coordinate and schedule meetings, travel arrangements, conferences, and departmental activities
• Maintain and organize filing systems, ensuring easy retrieval and proper documentation
• Manage high volumes of information, incoming calls, and correspondence
• Create and set up new claim files; transmit electronic reports to clients on the same day
• Respond promptly to client emails and ensure report distribution within one business day
• Sort, scan, and distribute incoming mail; draft responses to inquiries as needed
• Answer and manage phone calls, including handling routine and non-routine questions
• Handle confidential and sensitive information with discretion
• Support both independent and team-based projects, including ongoing and ad hoc assignments
• Prepare and format correspondence, memos, reports, charts, and presentations with a high degree of accuracy
• Proofread documents for spelling, grammar, clarity, and formatting

Administrative Assistant – Part-Time

Customer Support

• Participate in DLH training programs
• Gather medical records and other information needed to assess ongoing benefit eligibility
• Communicate with Policyholders and their authorized representatives and respond to verbal and written inquiries
• Record information in claim files and input data into electronic systems to track activities and claim status, to disburse benefits and to produce management reports
• Process, maintain and manage claim tasks and repetitive template payments for RPU/APU claims
• Responsible for requesting and filing Attending Physician Statements and Continuance of Disability forms on RPU/APU claims
• Participate in special projects as requested, and perform other related job functions as required
• Support company values of *We are Dynamic, We are Innovative, We are Connected, and We Succeed Together*