Hybrid Lead WC Claims Examiner — Resolution & Negotiation

AmTrust Financial Services Inc.; Boca Raton (FL); Hybrid; USD 75,000 - 115,000; Full time

Benefits offered by this job

Medical & Dental Plans

Life Insurance, including eligible ...

Health Care Flexible Spending

Dependent Care

401k Savings Plans

Paid Time Off

Job summary

AmTrust Financial Services is seeking a Workers' Compensation Examiner Lead in Boca Raton for prompt investigation, evaluation and settlement of claims. The role emphasizes effective negotiation, careful reserve management and collaboration with insureds, claimants and medical providers.

The Lead Examiner will work in a 4-day hybrid setup out of the Boca Office, handling larger or more complex claims with strong analytical and communication skills.

Qualifications

• Bachelor’s degree or equivalent experience.
• 3+ years WC claims handling experience.
• Demonstrated proficiency with MS Office suites.
• Demonstrated skills in investigation, evaluation and negotiation.
• Strong knowledge of insurance theory and practices.

Responsibilities

• Follows AmTrust policies and procedures in managing claims.
• Investigates the claim and coverage by contacting involved parties including insured, claimant, witnesses and medical providers.
• Evaluates, establishes, maintains, and adjusts reserves based on fact, company standard and experience.
• Skillfully negotiates claims and turns adverse perspectives into quick resolution.
• Gains trust of other parties to negotiations and demonstrates good sense of timing.
• Establishes effective relationships with internal or assigned counsel for customized defense plan.
• Coordinates with managed care and medical resources to develop return to work strategies and treatment plans for injured workers.
• Obtains medical records and agency reports as required.
• Provides insights and input when reviewing claims of others and offers advice when sought.
• Writes clearly and succinctly in claims files and other communications.
• Manages mail and diary entries effectively.
• Provides exceptional customer service.
• Performs other functional duties as requested or required.

Skills

Investigation

Evaluation

Negotiation

MS Office proficiency

Insurance theory

Education

Bachelor's degree or equivalent experience

Tools

MS Office

Job description

AmTrust Financial Services is seeking a Workers' Compensation Examiner Lead in Boca Raton for prompt investigation, evaluation and settlement of claims. The role emphasizes effective negotiation, careful reserve management and collaboration with insureds, claimants and medical providers.

The Lead Examiner will work in a 4-day hybrid setup out of the Boca Office, handling larger or more complex claims with strong analytical and communication skills.