Senior Claims Examiner I

AmTrust Financial Services•Tbd, CA

22h•$102,000 - $105,000•Hybrid

About The Position

The Worker’s Compensation Transitional Senior Claims Examiner plays a vital role in ensuring operational continuity within the Claims department. This specialized, full-time role is designed for seasoned professionals who can step in to manage open desks or oversee pending claims during an adjuster’s leave of absence. In addition to covering for employees on leave, a Transitional Senior Claims Examiner may also be deployed during periods of attrition or team transitions to maintain workflow and service standards. A Transitional Senior Claims Examiner is expected to uphold the standards of AmTrust and the Claims organization while maintaining a solid understanding of our mission, vision, and values. This role requires adaptability, strong technical knowledge, and the ability to work seamlessly across various teams and claim types. A valid California adjuster license is required for all Transitional Senior Claims Examiner . Those within a 50 mile radius of an AmTrust office will be expected to abide by a hybrid schedule.

Requirements

Bachelor’s degree or equivalent experience
5+ years claims handling experience
State licensure as required
Demonstrated proficiency with MS Office suites
Demonstrated skills in investigation, evaluation and negotiation
Strong knowledge of insurance theory and practices

Responsibilities

Investigates the claim or coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured or employer representatives, claimants or injured workers, witnesses and producers.
Determines, reviews and analyzes coverage.
While operating autonomously, elevates coverage issues as needed with appropriate resources and drafts positions as required.
Responsible for setting of timely and accurate reserves based on facts, company standard and experience.
Establishes effective litigation plan and build relationship with internal or panel counsel.
Applies company principles and standards including planning, organizing and monitoring legal panel services and cost in partnership with internal legal counsel.
Leverages strong critical thinking and decision-making skills to gather, assess, analyze, question, verify, interpret and understand key or root issues.
Skillfully negotiates claims after gaining effective leverage points to effectuate optimal outcome.
Gains trust of other parties to negotiations and demonstrates good sense of timing.
Approaches discussions from merits or strengths of case.
As part of a team, provides insights and input when reviewing claims of others.
May be sought out by others for advice.
Writes in a clear, succinct and fact-based manner in Claims files as well as in other communication.
Demonstrates timeliness in managing the diary ensuring fact based and up to date entries.
Establishes and maintains effective relationships with customers and gains their respect and trust.
May be required to work overtime as assigned.
Keeps current with market trends and demands.
Performs other functionally related duties as assigned.