Apply on Employer Site

AmTrust Financial Services, Inc. · 1 week ago

Claims Adjuster - Workers Compensation

US-TX-Dallas

Full-time

Hybrid

Mid Level

3+ years exp

AmTrust Financial Services, Inc. is seeking an experienced Workers Compensation Lost Time Adjuster to efficiently investigate workplace incidents and manage claims. The role involves analyzing coverage, communicating with stakeholders, and establishing reserves while upholding the company's mission and standards.

FinanceFinancial ServicesInsurance

Responsibilities

Analyzes coverage to ensure incident/accident and appropriate parties are covered by the claim policy. Reviews coverage issues with supervisor as needed

Investigates claims by making quality, timely and appropriate contact with involved or interested parties including but not limited to the insured or employer representatives, claimant, witnesses, producers and Amtrust colleagues

Obtains information and performs data management with attention to detail and accuracy to support to achieve timely submission of EDI and state regulatory filing requirements

Obtain, review, evaluate and document, medical records and reports, police, ambulance, agency reports, photographs or other documents relevant to claim management

Demonstrates ability to learn technical materials, leverages and builds critical thinking and decision-making skills to support quality action plans for effective and efficient claim management

Establishes reserves based on estimating most probable outcome of a claim based on the facts for the case and company standard. Adjust reserves based on facts, company standard and experience

Communicates timely and effectively with stakeholders, including but not limited to the insured or employer representatives, claimant, witnesses, producers and Amtrust colleagues

Build strong relationships, applying company principles and standards on matters with assigned legal counsel

Effectively evaluate and negotiate potential resolutions for litigated and non-litigated claims

Manages time and diary/task system effectively and efficiently. Ability to multi-task and prioritize work in a fast paced environment, maintaining quality and meeting deadlines

Writes in a clear, succinct and fact-based manner in Claims files as well as in other communication

Establishes and maintains effective relationships with internal and external business partners and customers, gaining their respect and trust

Seeks, receives and provides feedback and constructive criticism for continual learning and growth in the role

Performs other functional duties as requested or required

Qualification

Claims handling experienceInvestigation skillsNegotiation skillsInsurance theory knowledgeMS Office proficiencyCritical thinkingTime managementRelationship buildingFeedback acceptance