Claims Adjuster (Liability)

Claims Adjuster The Broward County Board of Commissioners Risk Management Division are seeking a detail-oriented and experienced Claims Adjuster to manage Liability claims for Broward County. This role involves investigating, analyzing, and resolving claims while ensuring compliance with state regulations and organizational policies. The ideal candidate will have strong negotiation skills, analytical ability, and experience handling complex claims. High Deductible Health Plan bi-weekly premiums: Single $10.90 / Family $80.79 Includes a County Funded Health Savings Account of up to $2000 Annually Consumer Driven Health Plan bi-weekly premiums: Single $82.58 / Family $286.79 Florida Retirement System (FRS) 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 2K annually) Performs advanced specialized technical work in the investigation and adjustment of public liability and/or Workers' Compensation claims. Works under general supervision, independently developing work methods and sequences. Review and analyze accident reports, property damage, and bodily injury claims to determine liability. Investigate Workers' Compensation and Liability claims, including gathering evidence, interviewing witnesses, and reviewing police reports and medical records. Negotiate claim settlements with internal leadership, legal teams, and claimants. Attend mediations and provide support to the County Attorney's office during the claims process. Authorize and coordinate medical treatment, property restoration, and other claim-related actions. Calculate and process indemnity and medical benefits, impairment ratings, and ensure timely payments to avoid penalties. Monitor work status, medical treatment, and discharge papers for accurate claim closure. Identify potential fraud, subrogation opportunities, and underwriting/safety risks. Maintain accurate documentation and comply with state-mandated reporting requirements. Collaborate with medical professionals, internal divisions, and legal counsel on complex cases. Requires two (2) years equivalent of higher-level education from an accredited college or university with major coursework in insurance, risk management, or closely related field. (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. Possession/retention of a Florida All-Lines Adjusters License (Type 6-20 or 7-20) from the State of Florida Division of Insurance Agent and Agency Services. Must possess and maintain a valid Florida Class E Driver's License for duration of appointment. Preference for Associate in Risk Management - (ARM), Certified Insurance Counselors (CIC), Chartered Property Casualty Underwriter (CPCU), Accredited Claims Adjuster (ACA), Associates in Claims (AIC) Certificate, Claims handling in Clearsight Enterprise claims software, 2+ years of experience handling subrogation claims, Bachelor's degree or higher in relevant field. The functions listed below are those that represent the majority of the time spent working in this class. Management may assign additional functions related to the type of work of the job as necessary. Reviews and analyzes reports of accidents including property damage and bodily injury to determine liability; reviews and analyzes Liability and/or Workers' Compensation claims and recommends appropriate action. Consults on injury cases with various medical personnel in order to ascertain the extent and cost of treatment, loss of earning capacity and prognosis; confers with County physician on employment limitations. Performs the calculation and payment of benefits whether indemnity and/or medical benefits, including entering all payments for benefits. Coordinates the gathering of formal evidence by taking photographs, preparing diagrams and making measurements at accident scene; arranges for witnesses to appear at legal proceedings; and prepares accident reports. For Workers Compensation claims the adjuster will contact the injured employee, employer, and medical provider to document the claim. For Liability claims the adjuster will contact the claimant, the division and any witnesses. Contacts injured employee, employer, and medical provider to document claim. Conducts field investigations, face-to-face statements with employees, employer representatives and witnesses to understand the nature of the claim and gain an understanding of what occurred prior to the claim. Negotiate claim settlements with the Director of Risk Management, the County Administrator, the County Attorney, claimants and/or their legal teams. Attend mediations with the County Attorneys office to support the claims process. Provide advice regarding potential fraud, subrogation, and underwriting/safety risk, and communication with counsel. Authorizes/coordinates medical treatment with walk-in facilities and specialists to update claim. Analyze complex information from different sources, such as police reports, videos from surveillance cameras or audio, and other information to further understand the incident. Make decisions for approvals of medical treatments and property restoration. Make determinations on liability or compensability for Workers Compensation claims. Apportion percentage of liability and negotiate settlement with claimant or claimant's attorney or Liability Claims. Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. Investigates liability claims; inputs data into the system association with findings. Calculates/processes timely disability benefits and impairment ratings of 1% or more when given to issue benefits to avoid penalties. Processes outgoing letters to injured employees and medical providers and places them on notice of action taking place. Sets up medical only claims to document/update current work status and treatment. Monitors/obtains discharge papers for impairment ratings and issues benefits when owed and paid within mandated timeframe to avoid penalties. Monitors work status for a disability of 7 days or less through discharge for closing a claim. Processes employee-received notices of outstanding medical bills to resolve non-payment issues. Reviews/corrects reporting by Center for Medicare/Medicaid Services (CMS) for accuracy. Denies/processes claims for non-work related injuries with timely electronic filing to avoid penalties. The Workers Compensation Adjuster calculates/processes disability benefits for impairment ratings of 1% or more when issuing benefits to avoid penalties. Sets up medical claims to document/update current work status and treatment. Monitors/obtains medical records and work status to ensure timely calculation and payment of indemnity and impairment ratings, complete State EDI mandated reporting within regulated time frames to avoid penalties. Processes employee-received notices of outstanding medical bills to resolve non-payment issues. Reviews/corrects reporting by Center of Medicare/Medicaid Services (CMS) for accuracy. For disability more than 8 days, initiates timely electronic filings to Division of Workers' Compensation. Conducts recorded interviews with employees and witnesses. Attends meetings with other Divisions, Professional Standards/Human Rights Section (PS/HRS), and Human Resources to discuss complex claims. Performs related work as assigned. Financial Acumen: Interprets and applies key financial indicators to make better business decisions. Determines and estimates the main direct and indirect costs; makes generally appropriate decisions regarding expenditures. Studies financial and quantitative information; uses data to improve performance. Decision Quality: Makes good and timely decisions that keep the organization moving forward. Knows when to act independently and when to escalate issues. Integrates various inputs, decision criteria, and trade-offs to make effective decisions. Typically makes good independent decisions. Optimizes Work Processes: Knows the most effective and efficient processes to get things done, with a focus on continuous improvement. Uses metrics and benchmarks to monitor accuracy and quality. Takes steps to make methods productive and efficient. Promptly and effectively addresses process breakdowns. Ensures Accountability: Holds self and others accountable to meet commitments. Accepts responsibility for own work, both successes and failures. Handles fair share and does not make excuses for problems. Usually meets commitments to others. Drives Results: Consistently achieves results, even under tough circumstances. Holds self to high standards of performance; sets some challenging goals; wants to achieve meaningful results; pursues initiatives/efforts to successful completion and closure. Focuses on key goals, even during setbacks and obstacles. Manages Conflict: Handles conflict situations effectively, with a minimum of noise. Seeks out a variety of opinions and options; maintains an open mind; takes steps to ensure conflict remains constructive; avoids

Created: 2026-03-08