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Senior Claims Resolution Specialist
2 months ago
Overview:
Summary:
The Senior Claims Resolution Specialist is tasked with the timely and independent assessment of insurance claims, utilizing effective research, evaluation, investigation, negotiation, and communication with insured parties, claimants, and legal representatives.
This position offers a preferred hybrid work schedule for candidates located within a specified distance from an AmTrust office.
The compensation range for this role is $85,000-$102,000, applicable for positions based in New York.
Base salary may vary based on factors such as education, experience, skills, geographic location, travel requirements, and performance metrics.
This range is subject to future adjustments.Key Responsibilities:
Key Responsibilities:
Conducts thorough investigations into claims or coverage by making timely and appropriate contact with relevant parties, including but not limited to insured individuals, employer representatives, claimants, witnesses, and agents.
Establishes reserves based on the most probable outcomes of claims, grounded in case facts and company standards. Adjusts reserves as necessary based on evolving facts and experiences.
Claims managed by a Senior Specialist may involve collaboration with internal or assigned legal counsel. Fosters strong relationships, applying company principles and standards in partnership with internal legal teams.
Effectively negotiates both litigated and non-litigated claims, earning the trust of negotiating parties and demonstrating keen timing.
Depending on the nature of the claim, may:
Engage with internal Managed Care and Medical resources to ensure alignment with medical providers regarding the development and authorization of suitable treatment plans and accurate billing.
Utilizes and enhances critical thinking and decision-making skills to gather, assess, analyze, question, verify, interpret, and comprehend key or underlying issues.
Exhibits the ability to assimilate technical materials and learn from past experiences.
Manages time and diary entries effectively and efficiently, prioritizing tasks in a dynamic environment.
Establishes and nurtures effective relationships with clients, earning their respect and trust.
Performs additional functional duties as required.
Unique
Unique Responsibilities:
Conducts basic compensability analysis based on AOE/COE investigations.
Verifies the nature and extent of injuries.
Identifies changes in claim exposure.
Possesses advanced technical knowledge and skills in claims and legal matters.
Demonstrates excellent written and verbal communication skills.
Ability to engage professionally at a high level with both internal and external parties.
Adapts easily to changing situations, requirements, or priorities.
Effectively influences others while maintaining positive relationships.
Skilled negotiator.
Qualifications:
Qualifications:
Bachelor's degree or equivalent experience
3+ years of experience in claims handling
Preferred experience in managing litigated or complex claims
State licensure as required
Proficient in MS Office applications
Demonstrated skills in investigation, evaluation, and negotiation
Strong understanding of insurance theory and practices
Willingness to travel as required for certain positions
Preferred:
Experience across multiple jurisdictions may be beneficial
CPCU, ARM, AIC, or other relevant claims certifications
What We Offer:
AmTrust Financial Services provides a competitive compensation package along with excellent opportunities for career advancement.
Our benefits include:
Medical & Dental Plans, Life Insurance covering eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.
AmTrust is committed to fostering a diverse and inclusive culture where the thoughts and ideas of all employees are valued and respected.
This commitment encompasses, but is not limited to, human differences related to race, ethnicity, gender, sexual orientation, culture, religion, or disabilities.
AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will maintain a competitive edge and remain an employer of choice. We view diversity as a business imperative, enabling us to attract, retain, and develop top talent. It is an integral aspect of our identity as a company, how we operate, and how we envision our future.
