Workers Compensation Lead Claim Examiner I

Lead Claims Examiner Overview The Lead Claims Examiner is responsible for prompt and efficient investigation, evaluation, and settlement or decline of insurance claims through effective research, negotiation, and interaction with insureds, claimants, and medical providers. The role maintains a solid understanding of AmTrust’s mission, vision, and values, and upholds the standards of AmTrust and the Claims organization. Responsibilities Follow AmTrust policies and procedures in managing claims. Investigate the claim and coverage by making timely contact with involved or interested parties including the insured, claimant, witnesses, and medical providers. Evaluate, establish, maintain, and adjust reserves based on facts, company standards, and experience. Negotiate claims skillfully, turning adverse perspectives into quick resolution, gaining trust, and demonstrating good timing. Leverage strong critical‑thinking and decision‑making skills to gather, assess, analyze, question, verify, interpret, and understand key or root issues. Establish effective relationships with internal or assigned counsel for customized defense plans, planning, organizing, and monitoring legal panel services and costs in partnership with internal legal counsel. Communicate with internal managed care and medical resources to coordinate with medical providers, injured workers, and employers in developing return‑to‑work strategies and treatment plans. Obtain medical records (past and present), police, ambulance, and other agency reports as required. Provide insights and input when reviewing claims of others, and be sought for advice. Write in a clear, succinct, and fact‑based manner in claims files and other communications. Manage mail and diary entries effectively and efficiently. Provide exceptional customer service. Perform other functional duties as requested or required. Qualifications 3+ years experience as a Workers' Compensation adjuster. Proficient in MS Office (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. AmTrust has the right to revise this job description at any time. Expected salary range: $75,000–$93,000 annual. What We Offer Medical & Dental Plans Life Insurance, including eligible spouses & children Health Care Flexible Spending Dependent Care 401(k) Savings Plans Paid Time Off AmTrust strives to create a diverse and inclusive culture where the thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences in race, ethnicity, gender, sexual orientation, culture, religion, or disabilities. AmTrust values excellence and recognizes that by embracing diverse backgrounds, skills, and perspectives, we sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain, and develop the best talent available. We see diversity as more than just policies and practices; it is an integral part of who we are, how we operate, and how we envision the future. #J-18808-Ljbffr AmTrust Financial Services, Inc.