Senior Workers' Comp Claim Examiner - Lead & Resolve

AmTrust Financial Services Inc.; Dallas, Northern (TX, KY); Hybrid; USD 70,000 - 90,000; Full time

Job summary

AmTrust Financial Services Inc. in Dallas, TX is seeking an experienced Senior Claim Examiner to manage complex workers' compensation claims from start to resolution.

You will investigate claims, determine compensability, set reserves, and negotiate settlements while mentoring junior examiners. The role requires 5+ years of workers' compensation claims experience, strong technical knowledge, and excellent negotiation, communication, and prioritization skills to handle a fast-paced caseload and

Qualifications

• MS Office experience, including 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

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

Skills

Negotiation skills

Verbal communication

Written communication

Time management

Tools

MS Office

Job description

AmTrust Financial Services Inc. in Dallas, TX is seeking an experienced Senior Claim Examiner to manage complex workers' compensation claims from start to resolution.

You will investigate claims, determine compensability, set reserves, and negotiate settlements while mentoring junior examiners. The role requires 5+ years of workers' compensation claims experience, strong technical knowledge, and excellent negotiation, communication, and prioritization skills to handle a fast-paced caseload and