Senior Claims Examiner

Posted Yesterday
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Scottsdale, AZ, USA
Hybrid
88K-112K Annually
Senior level
Insurance • Financial Services
The Role
Examines, investigates, negotiates, and resolves workers’ compensation claims. Responsibilities include contacting injured workers, medical providers, employers, and attorneys; validating claims under applicable statutes; reviewing medical bills and treatment plans; authorizing payments; answering claim-status questions; and managing litigation and settlement strategies. The role requires California or Arizona workers’ compensation experience, current continuing education, strong communication and negotiation skills, and effective workload prioritization.
Summary Generated by Built In
Overview

Responsible for the prompt and efficient examination, investigation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds and claimants, ensuring that company resources are utilized in a cost effective manner in the process.

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.
Qualifications
  • 5+ years experience as a Workers Comp adjuster with California claims or Arizona
  • Must be current on Continued Education Units
  • 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.

Preferred:

  • SIP license

This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position. AmTrust has the right to revise this job description at any time


The expected salary range for this role is $87,600.00 - $112,000.00 annual.


Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations


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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 or 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.

Skills Required

  • 5+ years of experience as a workers’ compensation adjuster with California claims experience or Arizona claims experience
  • Current Continuing Education Units (CEUs)
  • Microsoft Office experience, including Word, Excel, and Outlook
  • Effective negotiation skills
  • Strong verbal and written communication skills
  • Ability to prioritize workload and meet deadlines
  • Ability to manage multiple tasks in a fast-paced environment
  • SIP license
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The Company
HQ: New York, NY
4,104 Employees
Year Founded: 1998

What We Do

AmTrust Financial Services, Inc., through its subsidiaries, operates as a multinational property and casualty insurance company. Founded in 1998 to provide workers’ compensation insurance to small businesses in the United States, the company now operates in three segments around the globe: Small Commercial Business Insurance, Specialty Risk and Extended Warranty, and Specialty Middle-Market Property and Casualty Program Insurance.

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