Senior Claim Examiner I
AmTrust Financial
Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Senior Claims Examiner - WC.
The adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of worker's compensation insurance claims through effective research, negotiation and interaction with insures, and claimants, ensuring that company resources are utilized in a cost-effective manner in the process. The adjuster reports to a WC Supervisor.
Responsibilities
The adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of worker's compensation insurance claims through effective research, negotiation and interaction with insures, and claimants, ensuring that company resources are utilized in a cost-effective manner in the process. The adjuster reports to a WC Supervisor.
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.
- 5+ 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
Vacancy posted 3 days ago
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