Senior Claim Examiner I

AmTrust Financial Services, Inc.; Overland Park (KS); On-site; USD 65,000 - 85,000; Full time

Job summary

AmTrust Financial Services, Inc. in Overland Park, KS is seeking a Senior Claim Examiner to manage complex workers’ compensation claims from intake to resolution. The role requires 5+ years of claims experience, strong negotiation skills, and excellent verbal and written communication abilities.

You will mentor junior examiners and ensure compliance with state regulations while delivering exceptional service in a fast-paced environment.

Qualifications

• MS Office experience (Word, Excel, Outlook) required.
• Effective negotiation skills are essential.
• Strong verbal and written communication skills required.
• Ability to prioritize workload to meet deadlines.
• Ability to manage multiple tasks in a fast-paced environment.

Responsibilities

• Investigate and manage workers’ compensation claims from start to resolution.
• Review and analyze medical bills to ensure relation to injury and treatment plans.
• Ensure timely payments of medical bills and income replacement per fee schedules and statutes.
• Answer questions about claim status from claimants, policyholders and medical providers.
• Consult with attorneys regarding litigation management, settlement strategy and claim resolution.

Skills

MS Office

Negotiation

Communication

Time management

Multitasking

Job description

Overview

We are seeking experienced professionals to join our Workers’ Compensation team as a Senior Claim Examiner. Both positions play a critical role in managing workers compensation claim files and ensuring compliance with state regulations while delivering exceptional service.

Senior Claim Examiner

• Manage complex and high-exposure workers’ compensation claims from start to resolution.
• Investigate claims, determine compensability, set reserves, and negotiate settlements.
• Serve as a resource for junior examiners and assist with mentoring.
• Requires 5+ years of workers’ compensation claims experience and strong technical knowledge.

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

• MS Office experience (Work, Excel, Outlook)
• Effective negotiation skills
• Strong verbal and written communication skills
• Ability to prioritize work load to meet deadlines
• Ability to manage multiple tasks in a fast-paced environment