Program Claim Manager, Workers Compensation

AmTrust Financial Services, Inc.•,

2d•$87,600 - $120,000•Hybrid

About The Position

Amtrust Financial Services, a fast growing commercial insurance company, is seeking a Program Claims Manager. This position can be located in one of our claims offices, with the possibility of working remotely. The successful candidate will provide oversight of Third Party Administrators in the handling of Workers Compensation related claims. The successful candidate will evaluate coverage issues and risk transfer opportunities as well as ensuring appropriate investigations of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, and proper negotiation strategy is employed.

Requirements

Minimum of 7-10 years’ experience in the handling or litigating of complex workers compensation claims.
Proficient computer skills required to navigate our paperless claim file system.
Possesses a high level of technical claim and legal knowledge and skills.
Excellent communication skills both written and oral.
Ability to interact at a high level with parties both internal and external to AmTrust.
Easily adapts to changing situations requirements or priorities.
Ability to effectively influence others without damaging relationships.
Skillful negotiator.

Nice To Haves

Texas designated home state adjuster license preferred.
SCLA or CPCU designation/AIC certification preferred.

Responsibilities

Provides guidance, feedback, information to drive results through Third Party Administrators
Provide account management and oversight on assigned accounts
Assist in claim due diligence as part of the approval process for any new TPA or MGA/TPA partner
Lead new TPA program implementation process
Work with the data analytics team to evaluate TPA/Program performance and communicate results to internal/external partners
Draft, review and/or update service instructions for assigned programs
Partner with Internal parties to assist with all necessary regulatory and compliance reporting requirements
Ensure TPA compliance with best practices and litigation management guidelines
Escalate service issues involving TPA's and MGA's to senior management
Recognizing exposures and ensuring reserving is appropriate and timely
Evaluating coverage issues and risk transfer opportunities, with preference to candidates with claims-made policy coverage experience
Ensuring appropriate investigations of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, proper negotiation strategy is employed.
Effectively communicate exposures both internally and externally
Overall responsibility for formulating proper resolution strategy to ensure best total outcome.
Perform Claim Audits
Position may require periodic travel to attend meditations, trials and / or other related meetings
Perform other duties as assigned