Senior Claim Examiner I

Senior Claim ExaminerManage 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.Lead Claim ExaminerResponsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Maintains a solid understanding of AmTrust's mission, vision, and values. Upholds the standards of AmTrust and the Claims organization. Requires 3+ 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 statuteAnswer questions regarding the status of pending claims from claimants, policyholders and medical providers.Consult with attorneys regarding litigation management, settlement strategy and claim resolution.QualificationsMS Office experience (Work, Excel, Outlook)Effective negotiation skillsStrong verbal and written communication skillsAbility to prioritize work load to meet deadlinesAbility to manage multiple tasks in a fast-paced environment