Lead Claim Examiner I

AmTrust Financial Services, Inc.; Chicago (IL); Hybrid; USD 77,500 - 87,000; Full time

Benefits offered by this job

Medical & Dental Plans

Life Insurance

401k Savings Plans

Paid Time Off

Job summary

AmTrust Financial Services, Inc. is seeking a Lead Claims Examiner to promptly investigate, evaluate and settle or declinate workers' compensation claims.

The role requires strong negotiation, research and communication with insureds, claimants and medical providers, with a path to a hybrid schedule once the Oakbrook IL office opens. Based in Illinois, the position begins remotely and transitions to hybridwork.

Qualifications

• 3+ years experience as a Workers' Comp adjuster.
• MS Office experience (Word, Excel, Outlook).
• Effective negotiation skills.
• Strong verbal and written communication skills.
• Ability to prioritize workload to meet deadlines.
• Ability to manage multiple tasks in a fast-paced environment.

Responsibilities

• Follows AmTrust policies and procedures in managing claims.
• Investigates the claim and coverage by contacting insured, claimant, witnesses and medical providers.
• Evaluates, establishes and adjusts reserves based on facts and experience.
• Negotiates claims to reach timely resolutions.
• Coordinates with internal counsel for defense plans and cost control.
• Communicates with managed care and medical resources to support return-to-work plans.

Skills

Negotiation skills

Verbal and written communication

Time management

Multi-tasking

Tools

MS Office (Word, Excel, Outlook)

Job description

Overview

The Lead Claims Examiner is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of AmTrust and the Claims organization.

This position will start remotely with an expectation to transition to a hybrid schedule upon opening of our Oakbrook IL office.

Responsibilities

• Follows AmTrust policies and procedures in managing claims.
• Investigates the claim and coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured, claimant, witnesses and medical providers.
• Evaluates, establishes, maintains and adjusts reserves based on fact, company standard and experience.
• Skillfully negotiates claims, turning adverse perspectives into quick resolution. Gains trust of other parties to negotiations and demonstrates good sense of timing. Approaches discussions from merits or strengths of case.
• Leverages strong critical thinking and decision-making skills to gather, assess, analyze, question, verify, interpret and understand key or root issues.
• Establishes effective relationships with internal or assigned counsel for customized defense plan. Applies company principles and standards including planning, organizing and monitoring legal panel services and cost in partnership with internal legal counsel.
• Communicates with internal managed care and medical resources to ensure coordination with medical providers, injured workers and employers in developing return to work strategies and treatment plans.
• Obtains medical records (past and present), police, ambulance and other agency reports as required.
• Provides insights and input when reviewing claims of others. May be sought out by others for advice.
• Writes in a clear, succinct and fact‑based manner in claims files as well as in other communication.
• Manages mail and diary entries effectively and efficiently.
• Provides exceptional customer service.
• Performs other functional duties as requested or required.

Qualifications

• 3+ years experience as a Workers Comp adjuster.
• MS Office experience (Word, Excel, Outlook).
• Effective negotiation skills.
• Strong verbal and written communication skills.
• Ability to prioritize workload to meet deadlines.
• Ability to manage multiple tasks in a fast‑paced environment.

This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position. AmTrust has the right to revise this job description at any time.

The expected salary range for this role is $77,500‑87,000 annual. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations.

What We Offer

AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.

AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.