Qureos Mentor

DAVIES

<div><h3 class="jobSectionHeader"><b>Description</b></h3><div><b><br>
Our Story</b></div><div>
Imagine being part of a team that&rsquo;s not just shaping the future but actively driving it. At <b>Davies North America</b>, we&rsquo;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.</div><div>
<br>
We&rsquo;re currently seeking an experienced <b>Workers&rsquo; Compensation Legal Adjuster</b> to join our growing team. In this role, you&rsquo;ll manage Florida workers&rsquo; compensation claims, including litigated files, while ensuring compliance with Florida statutes and delivering exceptional service to our clients.<br>
<br>
This position will investigate and manage Florida workers&rsquo; compensation claims from assignment through resolution. You&rsquo;ll evaluate claim details, apply Florida statutes and case law to determine compensability, and establish appropriate reserves while ensuring timely payments and regulatory compliance.<br>
</div><div>You&rsquo;ll collaborate with defense counsel, nurse case managers, and clients while managing litigation strategy and maintaining a proactive approach to claim resolution.</div><br>
<h3 class="jobSectionHeader"><b>
Key Responsibilities</b></h3><br>
<ul>
<li>
Investigate and evaluate Florida workers&rsquo; compensation claims to determine compensability, exposure, and total claim value in accordance with Florida statutes and case law.</li>
<li>Establish and maintain appropriate reserves using reserving tools, ODG guidelines, and company reserving philosophy.</li>
<li>Initiate and manage indemnity payments and maintain diary systems for ongoing payments and claim activity.</li>
<li>Complete state-required filings and EDI reporting accurately and within required timelines.</li>
<li>Assign and coordinate with defense counsel on litigated claims and assist with litigation strategy.</li>
<li>Collaborate with Nurse Case Managers to monitor medical treatment and authorize appropriate medical services under Florida Statute 440.13.</li>
<li>Review and approve medical bills within required timeframes.</li>
<li>Determine need for vocational rehabilitation services to assist injured employees with return-to-work planning.</li>
<li>Coordinate light duty opportunities and workplace accommodations with employers and medical providers.</li>
<li>Maintain consistent communication with clients and attend client meetings as required.</li>
<li>Maintain accurate documentation, diaries, and workflow management to ensure regulatory compliance.</li>
<li>Identify potential subrogation or recovery opportunities and pursue appropriate reimbursement from responsible parties.</li>
<li>Protect Medicare&rsquo;s interests and ensure compliance with MMSEA Section 111 reporting requirements.</li>
<li>Monitor claims for red flags or potential fraud indicators.</li>
<li>Request reimbursement from excess carriers as required and follow up on outstanding recoveries.</li>
<li>Escalate client concerns or E&amp;O risks to leadership when appropriate.</li>
<li>Maintain performance expectations, including a 97% claim closure ratio.</li><br>
</ul><br>
<h3 class="jobSectionHeader"><b>Skills, knowledge &amp; expertise</b></h3><br>
<ul>
<li>
Workers&rsquo; compensation claims handling experience, including lost time and litigated claims</li>
<li>Active Florida All-Lines Adjuster License or Florida Workers&rsquo; Compensation License</li>
<li>Experience evaluating claims, setting reserves, and managing litigation files</li>
<li>Strong knowledge of Florida Workers&rsquo; Compensation statutes and rules</li>
<li>Experience coordinating with defense counsel and nurse case managers</li>
<li>Proficiency with Microsoft Office Suite</li>
<li>Excellent written and verbal communication skills</li>
<li>Strong organization, prioritization, and time-management skills in a fast-paced environment</li>
<li>Ability to work independently while collaborating with a team</li>
<li>Experience handling multiple claim types or presumption claims</li>
<li>Experience with depositions, mediations, and settlement negotiations</li>
<li>Familiarity with systems such as IDatix, Workers Computation, ISO, or ShoreTel</li><br>
</ul><br>
<h3 class="jobSectionHeader"><b>Benefits</b></h3><div><b><br>
Benefits</b></div><div>
At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:</div><ul>
<li>Medical, dental, and vision plans to ensure your health and that of your family.</li>
<li>A 401k plan with employer matching to help you build a secure financial future.</li>
<li>Our time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.</li>
<li>Paid holidays.</li>
<li>Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.</li>
</ul><div></div><div>
<b>Massachusetts Notice</b><br>
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.<br>
</div><div><b>Diversity and Inclusion</b></div><div>
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.<br>
<br>
<b>Compensation Transparency:</b>
<br>
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.
<br>
<br>
<i>We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at </i><i>recruitment@davies-group.com</i></div><br>
<h3 class="jobSectionHeader"><b>
About Davies</b></h3><div>
We are a specialist professional services and technology firm, working in partnership with leading insurance, highly regulated and global businesses.<br>
<br>
We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation &amp; risk, customer experience, human capital, digital transformation &amp; change management.<br>
<br>
Our global team of more than 8,000 professionals operate across ten countries, including the UK &amp; the U.S. Over the past ten years Davies has grown its annual revenues more than 20-fold, investing heavily in research &amp; development, innovation &amp; automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients.</div></div>

Workers’ Compensation Legal Adjuster

<div><h3 class="jobSectionHeader"><b>Description</b></h3><div><b><br>
Our Story</b></div><div>
Imagine being part of a team that&rsquo;s not just shaping the future but actively driving it. At <b>Davies North America</b>, we&rsquo;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.</div><div>
<br>
<b>What's in Store</b><br>
We are on the lookout for an experienced <b>Premium Audit Coordinator</b> who will work directly with the branch team to provide assistant functions to our field representatives. Reporting to the Branch Manager, you will perform a variety of tasks related to the preparation of reports and appointments. You will also spend time completing inbound calls with insureds and audit representatives to encourage the appropriate preparation for upcoming premium audits.</div><h3 class="jobSectionHeader"><b><br>
Key Responsibilities</b></h3><br>
<ul>
<li>
Acts as a liaison between the Phone Audit Manager and Phone Auditors to facilitate the flow of work</li>
<li>High call volume averaging 8-12 calls per hour during business hours</li>
<li>Acts as a liaison between insureds and field representatives when setting up audit or inspection appointments</li>
<li>Assists with determining needs, scheduling or cancelling appointments, or referring the insured to the correct staff person</li>
<li>Correspond with policyholders, CPA&rsquo;s, bookkeepers, agents to gather additional information as needed</li>
<li>Communicates audit needs to the insured to help ensure information is prepared for the Phone Auditor</li>
<li>Maintains and updates contact notes on each assigned job in AuSum</li>
<li>Makes calls to check on status of information including insurance agent calls</li>
<li>Handles all calls in a professional and welcoming manner and uses tact when explaining this process and reasoning for the inquiry</li>
<li>Attaches information and adds progress notes as it becomes available in AuSum</li>
<li>Assigns audits to Phone Auditors once information is received</li>
<li>Other duties as assigned</li>
</ul><div><br>
<b>This is a part-time (29 hours per week), remote role.</b></div><div></div><h3 class="jobSectionHeader"><b><br>
Skills, knowledge &amp; expertise</b></h3><br>
<ul>
<li>
Professional phone, chat, and email communication</li>
<li>High School Diploma or GED</li>
<li>Excellent computer skills including experience in the Microsoft Office Suite</li>
<li>Commitment to providing exceptional customer service</li>
<li>Communication: Balancing listening and talking, speaking, and writing clearly and accurately, influencing others, keeping others informed</li>
<li>Attention to Detail: Listen to information from policyholders and clients alike</li>
<li>Efficiency: Planning, managing time well, being on time, being cost conscious, thinking of better ways to do things</li>
<li>Multitasking: Handles distractions well, adaptable to new responsibilities; ability to quickly switch between tasks and adapt to changes easily</li>
<li>Proactive, independent, and takes initiative with consistent follow through</li>
<li>Superb communication skills, verbal and written, conducted in a timely manner</li>
<li>Superior time management skills with capability of working with and meeting deadlines</li>
<li>Exceptional capability to multi-task and prioritize with excellent organization and documentation skills in a fast-paced, dynamic work environment</li>
<li>Capable of working collaboratively and independently with minimal supervision</li>
<li>Exhibit discretion with sensitive and confidential information</li>
<li>Display a comfort level working with key people at all levels within an organization</li></ul><br>
<h3 class="jobSectionHeader"><b>
Benefits</b></h3><div><b><br>
Benefits</b></div><div>
At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:</div><ul>
<li>Medical, dental, and vision plans to ensure your health and that of your family.</li>
<li>A 401k plan with employer matching to help you build a secure financial future.</li>
<li>Our time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.</li>
<li>Paid holidays.</li>
<li>Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.</li>
</ul><div><b>Massachusetts Notice</b><br>
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.<br>
</div><div><b>Diversity and Inclusion</b></div><div>
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.<br>
<br>
<b>Compensation Transparency:</b>
<br>
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.
<br>
<br>
<i>We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at </i><i>recruitment@davies-group.com</i></div><br>
<h3 class="jobSectionHeader"><b>
About Davies</b></h3><div>
We are a specialist professional services and technology firm, working in partnership with leading insurance, highly regulated and global businesses.<br>
<br>
We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation &amp; risk, customer experience, human capital, digital transformation &amp; change management.<br>
<br>
Our global team of more than 8,000 professionals operate across ten countries, including the UK &amp; the U.S. Over the past ten years Davies has grown its annual revenues more than 20-fold, investing heavily in research &amp; development, innovation &amp; automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients.</div></div>

Premium Audit Coordinator (Part-Time, Remote)

<div><h3 class="jobSectionHeader"><b>Description</b></h3><div><b><br>
Our Story</b></div><div>
Imagine being part of a team that&rsquo;s not just shaping the future but actively driving it. At <b>Davies North America</b>, we&rsquo;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.</div><div>
<br>
We are on the lookout for an experienced and professional <b>Claim Recovery Specialist &ndash; </b>Property &amp; Casualty to join our team. The ideal candidate must possess a solid background in insurance claims handling, along with the appropriate demeanor to work effectively both under direction and independently. This position involves performing detailed reviews of potential auto and liability claims.The successful candidate will be an integral part of our subrogation unit, tasked with the review and analysis of potential subrogation claims. They will be responsible for pursuing and recovering claim funds in accordance with applicable laws and insurance policies. This role involves evaluating incoming claim information to identify recovery opportunities, primarily within the Property &amp; Casualty sector. It requires extensive experience and understanding of governmental entity risk pools.</div><br>
<h3 class="jobSectionHeader"><b>
Key Responsibilities</b></h3><br>
<ul>
<li>
Work within the subrogation unit to meticulously review potential subrogation claims</li>
<li>Conduct thorough investigations to pursue and recover claim funds in accordance with applicable laws and insurance policies</li>
<li>Analyze incoming claim information from various clients</li>
<li>Employ expertise in file investigations by obtaining and reviewing all necessary file documentation, i.e., police reports, video evidence, interviews, estimates, photographs and all other related information</li>
<li>Utilize extensive negotiation skills to effectively resolve claims and recover funds on behalf of clients</li>
<li>Responds promptly to communications from clients, customers and other insurance companies and/or attorneys</li>
<li>Perform other duties as assigned</li></ul><div></div><h3 class="jobSectionHeader"><b><br>
Skills, knowledge &amp; expertise</b></h3><br>
<ul>
<li>
Possess a college degree and/or possess a combination of education and experience</li>
<li>5 years insurance industry claims handling experience, with at least 3 years in handling property &amp; casualty claims</li>
<li>Analytical Proficiency: Strong analytical skills to assess claim details and determine the potential for recovery</li>
<li>Attention to Detail: Exceptional attention to detail to ensure accurate review and processing of claims</li>
<li>Organizational Skills: Strong organizational skills to manage multiple claims efficiently and effectively</li>
<li>Communication Skills: Excellent verbal and written communication skills to interact with clients and team members professionally</li>
<li>Technological Proficiency: Proficiency in Microsoft Word and Excel for documentation and data analysis</li>
<li>Independent and Collaborative Work: Ability to work independently as well as collaboratively within a collegial group setting, depending on the project requirements</li>
<li>Interpersonal Skills: Appropriate interpersonal skills to maintain a professional and consultative demeanor in all interactions</li></ul><br>
<h3 class="jobSectionHeader"><b>
Benefits</b></h3><div><b><br>
Benefits</b></div><div>
At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:</div><ul>
<li>Medical, dental, and vision plans to ensure your health and that of your family.</li>
<li>A 401k plan with employer matching to help you build a secure financial future.</li>
<li>Our time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.</li>
<li>Paid holidays.</li>
<li>Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.</li>
</ul><div></div><div>
<b>Massachusetts Notice</b><br>
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.<br>
</div><div><b>Diversity and Inclusion</b></div><div>
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.<br>
<br>
<b>Compensation Transparency:</b>
<br>
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.
<br>
<br>
<i>We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at </i><i>recruitment@davies-group.com</i></div><br>
<h3 class="jobSectionHeader"><b>
About Davies</b></h3><div>
We are a specialist professional services and technology firm, working in partnership with leading insurance, highly regulated and global businesses.<br>
<br>
We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation &amp; risk, customer experience, human capital, digital transformation &amp; change management.<br>
<br>
Our global team of more than 8,000 professionals operate across ten countries, including the UK &amp; the U.S. Over the past ten years Davies has grown its annual revenues more than 20-fold, investing heavily in research &amp; development, innovation &amp; automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients.</div></div>

Claim Recovery Specialist

<div><h3 class="jobSectionHeader"><b>Description</b></h3><div><b><br>
Our Story</b></div><div>
Imagine being part of a team that&rsquo;s not just shaping the future but actively driving it. At <b>Davies North America</b>, we&rsquo;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.</div><div>
<br>
We are seeking an experienced <b>Workers' Compensation Claim Adjuster</b> to manage complex claims and deliver timely, cost-effective resolutions while providing exceptional client service.<br>
<br>
This adjuster investigates, evaluates, and manages Workers&rsquo; Compensation claims with moderate to high complexity, including catastrophic losses and litigated matters. This role independently develops and executes strategic action plans to ensure claims are resolved appropriately, efficiently, and in compliance with jurisdictional requirements.</div><div></div><h3 class="jobSectionHeader"><b><br>
Key Responsibilities</b></h3><br>
<ul>
<li>
Determine compensability and extent of coverage on assigned claims.</li>
<li>Conduct thorough investigations, including interviews with employees, employers, and witnesses.</li>
<li>Obtain and review medical, hospital, police, employment, and other relevant records.</li>
<li>Manage EDI reporting and CMS Section 111 compliance.</li>
<li>Utilize approved preferred vendors and cost-containment resources.</li>
<li>Prepare comprehensive and accurate reports for clients and excess carriers.</li>
<li>Negotiate settlements with claimants and/or their attorneys.</li>
<li>Manage litigation strategy, legal vendors, and associated costs in accordance with account requirements.</li>
<li>Handle catastrophic losses, complex litigation files, and other sensitive matters.</li>
<li>Respond to client inquiries promptly and professionally.</li>
<li>Maintain required adjuster licensing and continuing education.</li>
<li>Stay current on jurisdictional regulations, industry trends, and best practices.</li>
<li>Mentor, train, and share technical expertise with team members as needed.</li>
<li>Perform additional duties as assigned.</li><br>
</ul><br>
<h3 class="jobSectionHeader"><b>Skills, knowledge &amp; expertise</b></h3><br>
<ul>
<li>
Active adjuster licenses as required by jurisdiction.</li>
<li>West Virginia Workers&rsquo; Compensation jurisdictional knowledge and handling experience.</li>
<li>Workers&rsquo; Compensation claims handling experience.</li>
<li>Strong knowledge of Workers&rsquo; Compensation laws, claims adjudication, and investigation practices.</li>
<li>Extensive understanding of medical and legal terminology.</li>
<li>Experience managing litigation and working with defense counsel.</li>
<li>Ability to handle multi-party investigations and complex claim scenarios.</li>
<li>Strong negotiation and settlement skills.</li>
<li>Proficiency with claims management systems and related software applications.</li>
<li>Ability to prepare clear, factual, and well-supported reports with recommendations.</li>
<li>Excellent written and verbal communication skills.</li>
<li>Strong organizational skills with the ability to meet time-sensitive deadlines.</li>
<li>Ability to manage confidential information with discretion.</li>
<li>Capacity to quickly adapt to evolving regulations and technology.</li>
<li>Ability to interpret and apply multi-state laws and regulations.</li><br>
</ul><br>
<h3 class="jobSectionHeader"><b>Benefits</b></h3><div><b><br>
Benefits</b></div><div>
At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:</div><ul>
<li>Medical, dental, and vision plans to ensure your health and that of your family.</li>
<li>A 401k plan with employer matching to help you build a secure financial future.</li>
<li>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.</li>
<li>Paid holidays.</li>
<li>Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.</li>
</ul><div><b>Massachusetts Notice</b><br>
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.<br>
</div><div><b>Diversity and Inclusion</b></div><div>
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.<br>
<br>
<b>Compensation Transparency:</b>
<br>
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.
<br>
<br>
<i>We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at </i><i>recruitment@davies-group.com</i></div><br>
<h3 class="jobSectionHeader"><b>
About Davies</b></h3><div>
We are a specialist professional services and technology firm, working in partnership with leading insurance, highly regulated and global businesses.<br>
<br>
We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation &amp; risk, customer experience, human capital, digital transformation &amp; change management.<br>
<br>
Our global team of more than 8,000 professionals operate across ten countries, including the UK &amp; the U.S. Over the past ten years Davies has grown its annual revenues more than 20-fold, investing heavily in research &amp; development, innovation &amp; automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients.</div></div>

Workers Compensation Claims Adjuster

Join DAVIES and explore 4   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

DAVIES

About Company

Workers’ Compensation Legal Adjuster

Premium Audit Coordinator (Part-Time, Remote)

Claim Recovery Specialist

Workers Compensation Claims Adjuster