Claims Adjuster-Worker's Compensation
Broward County, Florida, Fort Lauderdale, FL, United States
Job Summary
The Broward County Board of County Commissioners is seeking a detail-oriented, customer-focused Worker's Compensation Claims Adjuster to join the Risk Management Division. The role includes investigating, evaluating, and settling insurance claims in accordance with company policies and regulatory requirements while working closely with policyholders, legal representatives, and other stakeholders to ensure fair and timely resolution.
Benefits of Broward County Employment
High‑Deductible Health Plan – bi‑weekly premiums: Single $10.90 / Family $80.79
County Funded Health Savings Account up to $2000 annually
Consumer‑Driven Health Plan – bi‑weekly premiums: Single $82.58 / Family $286.79
Florida Retirement System – Pension or Investment Plan
457 Deferred Compensation employee match
Eleven (11) paid holidays each year
Vacation (Paid Time Off) – 2 weeks per year
Up to 40 hours of Job Basis Leave for eligible positions
Tuition Reimbursement – up to $2,000 annually
General Description
Performs advanced specialized technical work in investigating and adjusting public liability and/or Workers' Compensation claims.
Works under general supervision, independently developing work methods and sequences.
Calculates and processes disability benefits for impairment ratings of 1% or more, sets up medical claims, and monitors medical records to ensure timely payments.
Completes State EDI mandated reporting within regulated time frames to avoid penalties.
Reviews and corrects reporting by CMS for accuracy, manages employee‑received notices for outstanding medical bills, and resolves non‑payment issues.
Records and analyzes information from police reports, surveillance videos, and other sources to determine liability.
Minimum Education and Experience Requirements
Requires two (2) years of higher‑level education in Workers' Compensation and/or general liability claims adjusting and insurance/risk management. One year of relevant experience may be substituted for each year of required education.
Requires four (4) years in adjusting Workers' Compensation and/or bodily injury/property damage liability claims or closely related experience.
Special Certifications and Licenses
Florida All‑Lines Adjuster's License (Type 6-20 or 7-20)
Valid Florida Class E Driver's License for duration of appointment
Preferences
Associates in Claims (AIC) Certificate
Certified Insurance Counselors (CIC) or Chartered Property Casualty Underwriter (CPCU)
Certification in Workers' Compensation (CWC)
Accredited Claims Adjuster (ACA)
Bachelor's degree or higher in a related field
2+ years of experience in recorded statements
2+ years of experience responding to Conditional Payment demands from CMS
2+ years of experience negotiating workers' compensation lien recoveries
Scope of Work
Contact injured employee, employer, and medical provider to document the claim.
Conduct field investigations and obtain face‑to‑face statements with employees, employer representatives, and witnesses.
Consult with medical personnel to ascertain the extent and cost of treatment; confer with County physician on employment limitations.
Calculate and pay indemnity and/or medical benefits, entering all payments for benefits.
Initiate timely electronic filings to the Division of Workers' Compensation for disabilities >8 days.
Authorize and coordinate medical treatment with walk‑in facilities and specialists.
Process outgoing letters to injured employees and medical providers and place them on notice.
Set up medical‑only claims and monitor work status throughout the claim lifecycle.
Resolve non‑payment issues through employee‑received notices of outstanding medical bills.
Denial or processing of claims for non‑work‑related injuries with electronic filing.
Conduct recorded interviews with employees and witnesses.
Analyze reports of accidents (property damage, bodily injury) to determine liability and recommend action.
Gather formal evidence by taking photographs, preparing diagrams, and making measurements at the accident scene; arrange witnesses for legal proceedings.
Negotiate claim settlements with the Director of Risk Management, County Administrator, County Attorney, claimants, and/or their legal teams.
Attend mediations with the County Attorney's office to support the claims process.
Provide advice regarding potential fraud, subrogation, underwriting/safety risk, and communication with counsel.
Make decisions on approval of medical treatments, property restoration, liability, and compensability for Workers' Compensation claims.
Review police reports, medical treatment records, medical bills, or physical property damage to determine liability.
Investigate liability claims and input data into the system.
Attend meetings with other Divisions, Professional Standards/Human Rights Section (PS/HRS), and Human Resources.
Perform related work as assigned.
Work Environment
Physical Demands
– Sedentary work that involves walking or standing some of the time and may require exerting up to 10 pounds of force on a regular basis, along with sustained keyboard operations.
Unavoidable Hazards
– None.
Competencies
Financial Acumen
– Interprets and applies key financial indicators to make better business decisions.
Decision Quality
– Makes good and timely decisions that keep the organization moving forward.
Optimizes Work Processes
– Uses metrics and benchmarks to monitor accuracy and quality; continuously improves processes.
Ensures Accountability
– Holds self and others accountable to meet commitments.
Drives Results
– Consistently achieves results, even under tough circumstances.
Manages Conflict
– Handles conflict situations effectively and constructively.
Communicates Effectively
– Develops and delivers clear communications tailored to audiences.
Situational Adaptability
– Adapts approach and demeanor in real time to meet changing demands.
County Core Values
Collaborates
– Builds partnerships and works collaboratively with others.
Customer Focus
– Builds strong customer relationships and delivers customer‑centric solutions.
Instills Trust
– Gaining the confidence and trust of others through honesty, integrity, and authenticity.
Values Differences
– Recognizes the value that different perspectives and cultures bring to an organization.
Equal Opportunity / ADA Compliance
Broward County is an equal‑opportunity employer committed to inclusion. Qualified persons with disabilities may request reasonable accommodations by contacting the Professional Standards Section at 954‑357‑6500 or via email Profstandards@broward.org.
Emergency Management Responsibilities
During emergency conditions, all County employees are automatically considered emergency service workers and may be called to work in the event of a disaster or other emergency.
County‑wide Employee Responsibilities
All employees must serve the public and fellow employees with honesty and integrity in accordance with the County’s Employee Code of Ethics, gift, and conflict of interest policies.
Employees must establish and maintain effective working relationships with the general public, co‑workers, elected and appointed officials, and members of diverse cultural and linguistic backgrounds, respecting diversity and inclusion in all aspects of work.
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The Broward County Board of County Commissioners is seeking a detail-oriented, customer-focused Worker's Compensation Claims Adjuster to join the Risk Management Division. The role includes investigating, evaluating, and settling insurance claims in accordance with company policies and regulatory requirements while working closely with policyholders, legal representatives, and other stakeholders to ensure fair and timely resolution.
Benefits of Broward County Employment
High‑Deductible Health Plan – bi‑weekly premiums: Single $10.90 / Family $80.79
County Funded Health Savings Account up to $2000 annually
Consumer‑Driven Health Plan – bi‑weekly premiums: Single $82.58 / Family $286.79
Florida Retirement System – Pension or Investment Plan
457 Deferred Compensation employee match
Eleven (11) paid holidays each year
Vacation (Paid Time Off) – 2 weeks per year
Up to 40 hours of Job Basis Leave for eligible positions
Tuition Reimbursement – up to $2,000 annually
General Description
Performs advanced specialized technical work in investigating and adjusting public liability and/or Workers' Compensation claims.
Works under general supervision, independently developing work methods and sequences.
Calculates and processes disability benefits for impairment ratings of 1% or more, sets up medical claims, and monitors medical records to ensure timely payments.
Completes State EDI mandated reporting within regulated time frames to avoid penalties.
Reviews and corrects reporting by CMS for accuracy, manages employee‑received notices for outstanding medical bills, and resolves non‑payment issues.
Records and analyzes information from police reports, surveillance videos, and other sources to determine liability.
Minimum Education and Experience Requirements
Requires two (2) years of higher‑level education in Workers' Compensation and/or general liability claims adjusting and insurance/risk management. One year of relevant experience may be substituted for each year of required education.
Requires four (4) years in adjusting Workers' Compensation and/or bodily injury/property damage liability claims or closely related experience.
Special Certifications and Licenses
Florida All‑Lines Adjuster's License (Type 6-20 or 7-20)
Valid Florida Class E Driver's License for duration of appointment
Preferences
Associates in Claims (AIC) Certificate
Certified Insurance Counselors (CIC) or Chartered Property Casualty Underwriter (CPCU)
Certification in Workers' Compensation (CWC)
Accredited Claims Adjuster (ACA)
Bachelor's degree or higher in a related field
2+ years of experience in recorded statements
2+ years of experience responding to Conditional Payment demands from CMS
2+ years of experience negotiating workers' compensation lien recoveries
Scope of Work
Contact injured employee, employer, and medical provider to document the claim.
Conduct field investigations and obtain face‑to‑face statements with employees, employer representatives, and witnesses.
Consult with medical personnel to ascertain the extent and cost of treatment; confer with County physician on employment limitations.
Calculate and pay indemnity and/or medical benefits, entering all payments for benefits.
Initiate timely electronic filings to the Division of Workers' Compensation for disabilities >8 days.
Authorize and coordinate medical treatment with walk‑in facilities and specialists.
Process outgoing letters to injured employees and medical providers and place them on notice.
Set up medical‑only claims and monitor work status throughout the claim lifecycle.
Resolve non‑payment issues through employee‑received notices of outstanding medical bills.
Denial or processing of claims for non‑work‑related injuries with electronic filing.
Conduct recorded interviews with employees and witnesses.
Analyze reports of accidents (property damage, bodily injury) to determine liability and recommend action.
Gather formal evidence by taking photographs, preparing diagrams, and making measurements at the accident scene; arrange witnesses for legal proceedings.
Negotiate claim settlements with the Director of Risk Management, County Administrator, County Attorney, claimants, and/or their legal teams.
Attend mediations with the County Attorney's office to support the claims process.
Provide advice regarding potential fraud, subrogation, underwriting/safety risk, and communication with counsel.
Make decisions on approval of medical treatments, property restoration, liability, and compensability for Workers' Compensation claims.
Review police reports, medical treatment records, medical bills, or physical property damage to determine liability.
Investigate liability claims and input data into the system.
Attend meetings with other Divisions, Professional Standards/Human Rights Section (PS/HRS), and Human Resources.
Perform related work as assigned.
Work Environment
Physical Demands
– Sedentary work that involves walking or standing some of the time and may require exerting up to 10 pounds of force on a regular basis, along with sustained keyboard operations.
Unavoidable Hazards
– None.
Competencies
Financial Acumen
– Interprets and applies key financial indicators to make better business decisions.
Decision Quality
– Makes good and timely decisions that keep the organization moving forward.
Optimizes Work Processes
– Uses metrics and benchmarks to monitor accuracy and quality; continuously improves processes.
Ensures Accountability
– Holds self and others accountable to meet commitments.
Drives Results
– Consistently achieves results, even under tough circumstances.
Manages Conflict
– Handles conflict situations effectively and constructively.
Communicates Effectively
– Develops and delivers clear communications tailored to audiences.
Situational Adaptability
– Adapts approach and demeanor in real time to meet changing demands.
County Core Values
Collaborates
– Builds partnerships and works collaboratively with others.
Customer Focus
– Builds strong customer relationships and delivers customer‑centric solutions.
Instills Trust
– Gaining the confidence and trust of others through honesty, integrity, and authenticity.
Values Differences
– Recognizes the value that different perspectives and cultures bring to an organization.
Equal Opportunity / ADA Compliance
Broward County is an equal‑opportunity employer committed to inclusion. Qualified persons with disabilities may request reasonable accommodations by contacting the Professional Standards Section at 954‑357‑6500 or via email Profstandards@broward.org.
Emergency Management Responsibilities
During emergency conditions, all County employees are automatically considered emergency service workers and may be called to work in the event of a disaster or other emergency.
County‑wide Employee Responsibilities
All employees must serve the public and fellow employees with honesty and integrity in accordance with the County’s Employee Code of Ethics, gift, and conflict of interest policies.
Employees must establish and maintain effective working relationships with the general public, co‑workers, elected and appointed officials, and members of diverse cultural and linguistic backgrounds, respecting diversity and inclusion in all aspects of work.
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