Senior Workers' Comp Claims Examiner

AmTrust Financial Services, Inc.; New York (NY); On-site; USD 70,000 - 90,000; 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 Claim Examiner to investigate, evaluate and settle or declinate insurance claims with promptness and professionalism.

The role requires strong negotiation, communication, and decision-making skills to manage reserves and coordinate with medical providers and stakeholders. The candidate will engage with insureds, claimants, and providers, maintaining clear documentation and delivering exceptional customer service while navigating fast-paced

Qualifications

• 3+ years experience as a Workers Comp adjuster.
• 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.

Responsibilities

• 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.
• Gleans input from internal or assigned counsel for customized defense plan 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.
• Writes in a clear, succinct and fact-based manner in claims files as well as in other communication.
• Provides exceptional customer service.

Skills

Negotiation skills

Verbal and written communication

Prioritization

Multitasking

Tools

MS Office

Job description

AmTrust Financial Services, Inc. is seeking a Lead Claim Examiner to investigate, evaluate and settle or declinate insurance claims with promptness and professionalism.

The role requires strong negotiation, communication, and decision-making skills to manage reserves and coordinate with medical providers and stakeholders. The candidate will engage with insureds, claimants, and providers, maintaining clear documentation and delivering exceptional customer service while navigating fast-paced