Aspiring Workers’ Comp Claims Adjuster

Argo Group; New Mexico; On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k)

Job summary

Argo Group, an insurer of workers’ compensation for mining industries, seeks a Workers’ Compensation Claims Trainee to work from home in New Mexico or from our Omaha office. The role reports to a manager in Rockwood, PA and focuses on adjudicating medical-only claims initially, with training on low‑complexity indemnity claims.

Under close supervision, you will interview injured workers, employers, and providers, set reserves, deny non‑compensable claims where appropriate, and ensure timely

Qualifications

• High School diploma required; a Bachelor's degree can substitute 5 of the 6 years of experience.
• At least six years’ experience adjudicating medical-only claims or in insurance/healthcare.
• Licensed Claims Examiner per state requirements or ability to obtain license.

Responsibilities

• Investigate compensability by interviewing injured workers, employers, medical providers, and others.
• Manage medical-only claims and Black Lung claims already reviewed, with a schedule of benefits.
• Ensure timely and accurate medical payments; monitor biweekly/monthly benefit payments.
• Deny non-compensable claims and defend decisions if challenged.
• Set claim reserves and maintain diaries to ensure timely resolutions.
• Prepare reports and document files; process mail and prioritize workload.

Skills

Medical claims experience

Communication skills

Time management

Attention to detail

Customer service

Education

High School diploma

Bachelor's degree substitution (5 of 6 years)

Tools

MS Office Suite

Job description

Argo Group, an insurer of workers’ compensation for mining industries, seeks a Workers’ Compensation Claims Trainee to work from home in New Mexico or from our Omaha office. The role reports to a manager in Rockwood, PA and focuses on adjudicating medical-only claims initially, with training on low‑complexity indemnity claims.

Under close supervision, you will interview injured workers, employers, and providers, set reserves, deny non‑compensable claims where appropriate, and ensure timely