Senior Workers' Comp Claims Specialist

AmTrust Financial Services Inc.; Town of Florida (NY); Hybrid; USD 85,000 - 110,000; Full time

Job summary

AmTrust Financial Services Inc. seeks a Senior Claim Examiner to manage complex workers' compensation claims from start to resolution in New York. You will investigate claims, determine compensability, set reserves, and negotiate settlements, while mentoring junior examiners.

This role requires 5+ years of workers' comp claims experience, strong negotiation and communication skills, and the ability to handle multiple tasks in a fast-paced environment within a compliance-driven setting.

Qualifications

• 5+ years of workers' compensation claims experience.
• Strong negotiation, verbal and written communication skills.
• Ability to prioritize workload and manage multiple tasks in a fast-paced environment.

Responsibilities

• Investigate workers' compensation claims by contacting injured workers, medical providers, and employer representatives; determine compensability and authorize treatment plans.
• Review medical bills to confirm charges and treatment relate to workers' comp and comply with plans.
• Ensure timely payment of medical bills and income replacement per fee schedules and statutes.
• Answer questions on claim status from claimants, policyholders, and medical providers.
• Consult with attorneys on litigation management, settlement strategy and claim resolution.

Skills

Negotiation skills

Verbal communication

Written communication

Prioritization

Task management

Tools

MS Office (Word, Excel, Outlook)

Job description

AmTrust Financial Services Inc. seeks a Senior Claim Examiner to manage complex workers' compensation claims from start to resolution in New York. You will investigate claims, determine compensability, set reserves, and negotiate settlements, while mentoring junior examiners.

This role requires 5+ years of workers' comp claims experience, strong negotiation and communication skills, and the ability to handle multiple tasks in a fast-paced environment within a compliance-driven setting.