Senior Claim Examiner I

Overview The Lead Claim Examiner is responsible 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. Responsibilities FollowsAmTrustpoliciesandproceduresinmanagingclaims. Investigatestheclaimandcoveragebymakingtimelyandappropriatecontactwithinvolvedorinterestedpartiesincludingbutnotlimitedtotheinsured,claimant,witnessesandmedicalproviders. Evaluates,establishes,maintainsandadjustsreservesbasedonfact,companystandardandexperience. Skillfullynegotiatesclaims,turningadverseperspectivesintoquickresolution.Gainstrustofotherpartiestonegotiationsanddemonstratesgoodsenseoftiming.Approachesdiscussionsfrommeritsorstrengthsofcase. Leveragesstrongcriticalthinkinganddecision-makingskillstogather,assess,analyze,question,verify,interpretandunderstandkeyorrootissues. Establisheseffectiverelationshipswithinternalorassignedcounselforcustomizeddefenseplan.Appliescompanyprinciplesandstandardsincludingplanning,organizingandmonitoringlegalpanelservicesandcostinpartnershipwithinternallegalcounsel. Communicateswithinternalmanagedcareandmedicalresourcestoensurecoordinationwithmedicalproviders,injuredworkersandemployersindevelopingreturntoworkstrategiesandtreatmentplans. Obtainmedicalrecords(pastandpresent),police,ambulanceandotheragencyreportsasrequired. Providesinsightsandinputwhenreviewingclaimsofothers.Maybesoughtoutbyothersforadvice. Writesinaclear,succinctandfact-basedmannerinclaimsfilesaswellasinothercommunication. Managesmailanddiaryentrieseffectivelyandefficiently. Providesexceptionalcustomerservice. Performsotherfunctionaldutiesasrequestedorrequired. Qualifications 3+yearsexperienceasaWorkersCompadjuster MSOfficeexperience(Work,Excel,Outlook) Effectivenegotiationskills Strongverbalandwrittencommunicationskills Abilitytoprioritizeworkloadtomeetdeadlines Abilitytomanagemultipletasksinafast-pacedenvironment What We Offer AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off. AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion and disabilities. AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills and perspectives of its workforce, it will 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 as a company, how we operate and how we see our future. #J-18808-Ljbffr