Title

Senior Claims Examiner 


About the Organization AmTrust Financial Services, Inc., (Nasdaq: AFSI) headquartered in New York City, is a multinational insurance holding company, which, through its insurance carriers, offers specialty property and casualty insurance products, including workers' compensation, commercial automobile and general liability; extended service and warranty coverage. For more information about AmTrust, visit www.amtrustgroup.com, or call AmTrust toll-free at 866.203.3037.  

Position Claims Ex Sr  

Location CA, San Diego  

Description Workers Compensation Sr. Claims Examiner
Location: San Diego

Job Summary:
Responsible for managing an assigned number of Workers' Compensation claims, ensuring adherence to government regulations, timely, accurate and cost-effective management and settlement of each case. May serve as department expert in training staff and management.

Job Duties:
Responsibilities included but are not limited to:
• Provide superior customer service by returning a telephone calls and email correspondence within a timely manner and answering callers' basic questions regarding claims.
• Determine and resolve issues of coverage, compensability and liability, in order to delay, accept or deny claims within the statutory time constraints.
• Administer benefits of temporary disability, permanent disability, vocation rehabilitation and medical treatment in compliance with the CA State Workers' Compensation Laws, Federal Laws and company guidelines
• Prepare claims defense to mitigate liability by effectively using defense medical evaluations, QMEs, AMEs, investigations, depositions, and to pursue subrogation where applicable
• Review all files on a 30 day diary, addressing reserves, mail, issue identification, strategy development, follow-up and aggressive action.
• Participate in negotiation process by attending hearings and providing deposition and testimony to ensure cost effective resolution of each case
• Interact and effectively communicate via telephone, electronic, and written correspondence with claimants, attorneys, doctors, counselors, investigators, agents, and insureds.
• Interact and effectively communicate and work with team members, Supervisors, Management and others, demonstrating professional courtesy at all times
• Continue training and development (seminars, classes) to keep abreast of changing laws and procedures and to enhance file handling techniques.
• Maintain certification and licensing as required by CA law
• Serve as the liaison between the company and the insured, and conduct regular claims reviews with the insured and broker
• Advise Examiners and Assistants on technical questions
 

Position Requirements Job Requirements:
• Bachelor's degree or equivalent in work experience
• 3+ years experience as a claims examiner or assistant
• SIP certificate or obtained within one year required
• Full knowledge of related government laws and regulations
• General computer knowledge and experience with Microsoft Office Suite (Word, Excel, Access, Powerpoint)
• Ability to analyze and organize information
• Exceptional time management skills
• Strong verbal and written communication skills
• Ability to supervise, coach, and lead team of Examiners and Assistants when necessary
 

Open Date 8/30/2013  

Full-Time/Part-Time Full-Time  

Req Number CLA-13-00203  

Shift  

Number of Openings 1  


This position is currently not accepting applications.

To search for an open position, please go to http://AmTrustNorthAmerica.appone.com



WE ALSO RECOMMEND

Other Jobs Within Same Category
Subrogation Claim Assistant II in Dallas, TX
Posted on: 4/21/2014
[Apply Now]

Underwriter Assistant in Remote, PA
Posted on: 4/21/2014
[Apply Now]

Implementations Manager in St. Louis Park, MN
Posted on: 4/21/2014
[Apply Now]

Summer Internship: Financial Institution Division Underwriting Assistant Internship in Cleveland, OH
Posted on: 4/17/2014
[Apply Now]

Senior Workers Compensation Claims Adjuster in Boca Raton, FL
Posted on: 4/16/2014
[Apply Now]


Other Jobs Within 60 Miles
Workers Compensation Claims Supervisor in Irvine, CA
Posted on: 4/2/2014
[Apply Now]

Surety Claims Assistant in Irvine, CA
Posted on: 4/7/2014
[Apply Now]

Workers Compensation Claims Assistant II in San Diego, CA
Posted on: 4/21/2014
[Apply Now]

Assistant Claims Manager in Irvine, CA
Posted on: 3/11/2014
[Apply Now]

Senior Specialty Underwriter in Irvine, CA
Posted on: 4/1/2014
[Apply Now]

Follow us
 


AppOne.comTM   copyrightŠ1999-2013 HR Services, Inc.
Click here for technical assistance.