Job Details

Medical Only Adjuster

Department: Claims Administration & Adjusting

Employment Type: Permanent - Full Time

Location: Lakewood Ranch, FL

Reporting To: Claudia Cooke

Compensation: $44,000 - $52,000 / year

Description

Our Story

Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America, we're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

Davies is seeking a detail-oriented and proactive Medical Only Adjuster to manage workers' compensation medical-only claims for assigned TPA clients. This role requires strong knowledge of Florida Workers' Compensation statutes, independent judgment, and the ability to deliver timely, compliant, and high-quality claims handling while maintaining exceptional service standards.

Key Responsibilities

• Investigate and adjust medical-only Workers' Compensation claims in compliance with Florida statutes and case law
• Complete timely 48-hour contacts with injured workers, employers, and medical providers
• Determine compensability, authorize medical treatment, and initiate required state and EDI filings
• Review, document, and approve medical bills within required timeframes
• Monitor medical care and coordinate return-to-work and light duty accommodations
• Establish and maintain appropriate reserves and diary/workflow compliance
• Maintain regular communication with injured workers and clients to ensure service quality
• Identify red flags, recovery opportunities, and escalate concerns as appropriate
• Meet performance standards, including claim closure and quality metrics
• Participate in required training, client meetings, and ongoing professional development

Skills, knowledge & expertise

• Working knowledge of Florida Workers' Compensation law, rules, procedures, and case law
• Understanding of liability principles, medical terminology, and treatment protocols
• Strong organizational skills with the ability to manage multiple priorities
• Excellent written and verbal communication skills
• Ability to independently manage a medical-only caseload while meeting performance metrics
• Strong attention to detail and commitment to compliance and quality

Benefits

Benefits

At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and vision plans to ensure your health and that of your family.
• A 401k plan with employer matching to help you build a secure financial future.
• Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
• Paid holidays.
• Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

Diversity and Inclusion

Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.