Lead Claims Examiner I - Workers Compensation

AmTrust Financial Services, Inc.; California (MO); Hybrid; USD 45,460 - 53,726; Full time

Benefits offered by this job

Medical & Dental Plans

Life Insurance

401k Savings Plans

Paid Time Off

Job summary

A leading insurance provider is seeking a Workers Comp Adjuster in California. Responsibilities include investigating claims, reviewing medical bills, and ensuring timely payments. The ideal candidate has 2+ years of relevant experience, strong communication skills, and proficiency in MS Office. This role offers a competitive salary range of $33/hr to $39/hr, along with excellent benefits and advancement opportunities in a hybrid work environment.

Qualifications

• 2+ years of experience as a Workers Comp adjuster handling California claims.
• Must be current on Continued Education Units.
• Strong verbal and written communication skills required.

Responsibilities

• Thoroughly investigate workers’ compensation claims.
• Review and analyze medical bills for accuracy.
• Ensure payments for medical bills are timely.

Skills

Workers Comp adjusting experience

Communication skills

MS Office proficiency

Ability to prioritize workload

Job description

Job Overview

Responsible for the prompt and efficient examination, investigation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds and claimants, ensuring that company resources are utilized in a cost effective manner in the process.

Those within a 50-mile radius of an AmTrust office will be expected to abide by a hybrid schedule.

Responsibilities

• Thoroughly investigating workers’ compensation claims by contacting injured workers, medical providers, and employer representatives. Determining if claims are valid under applicable workers’ comp statutes. Communicating with medical providers to develop and authorize appropriate treatment plans.
• Reviewing and analyzing medical bills to confirm charges and treatment are workers’ comp injury-related and in accordance with the treatment plan.
• Ensuring payments for medical bills and income replacement are remitted on a timely basis in accordance with applicable fee schedules and statute.
• Answer questions regarding the status of pending claims from claimants, policyholders and medical providers.
• Consult with attorneys regarding litigation management, settlement strategy and claim resolution.

Qualifications

• 2+ years experience as a Workers Comp adjuster handling California claims
• Must be current on Continued Education Units
• MS Office experience (Word, Excel, Outlook)
• Strong verbal and written communication skills
• Ability to prioritize work load to meet deadlines
• Ability to manage multiple tasks in a fast-paced environment

Preferred

• SIP license

The expected salary range for this role is $33/hr-$39/hr.

Please note that the salary information shown above is a general guideline only. 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.

Diversity & Inclusion

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.