Lead Claims Examiner

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Claims Adjuster II - WC. The adjuster is responsible for the prompt and efficient examination, investigation, settlement, or declination of workers compensation insurance claims through effective research, negotiation, and interaction with insureds and claimants, ensuring that company resources are utilized in a cost-effective manner. Responsibilities: Thoroughly investigate workers compensation claims by contacting injured workers, medical providers, and employer representatives. Determine if claims are valid under applicable workers comp statutes. Communicate with medical providers to develop and authorize appropriate treatment plans. Review and analyze medical bills to confirm charges and treatment are related to workers comp injury and in accordance with the treatment plan. Ensure payments for medical bills and income replacement are remitted on a timely basis in accordance with applicable fee schedules and statutes. 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: 3+ years of Workers Compensation experience in New England States, preferably Massachusetts or Connecticut (NH, MA, NY, NJ, RI, or CT). Licenses in NH, VT, and RI. MS Office experience (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. This job description provides a general overview of the job requirements and does not include all activities, duties, or responsibilities that may be required. AmTrust reserves the right to revise this description at any time. #LI-GH1 #LI-HYBRID 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. We strive to create a diverse and inclusive culture where the ideas and perspectives of all employees are valued. Diversity encompasses human differences related to race, ethnicity, gender, sexual orientation, culture, religion, or disabilities. We believe that embracing diversity helps us attract, retain, and develop the best talent, and is integral to our companys success and future growth. #J-18808-Ljbffr