Claims Examiner Specialist

3 days ago

Latham, New York, United States AmTrust Financial Full time

Overview

This role is an excellent opportunity for a skilled and detail-oriented professional to join our team at AmTrust Financial Services. As a TCA Quality Assurance Specialist, you will play a vital part in maintaining the integrity and efficiency of our claims process.

About the Role

We are seeking a highly motivated and organized individual with experience in quality assurance, risk management, or compliance to fill this key position. In this role, you will be responsible for executing quality reviews on claims for Workers' Compensation lines of coverage.

Responsibilities

  • Conduct Claim File Audits: Regularly review claim files to ensure compliance with company standards and regulatory requirements.
  • Provide Feedback: Offer constructive feedback on audit results and suggest improvements to enhance claim processing quality.
  • Develop Quality Improvement Strategies: Assist in creating and implementing strategies to improve the overall quality of claims handling.
  • Analyze Data: Create and review reports on claim quality trends to identify areas of opportunity and make recommendations for process improvements.
  • Training and Support: Assist in providing training sessions to claims staff to improve their knowledge and skills.

Requirements

  • Bachelor's Degree: A related field OR equivalent business experience.
  • Experience: 5+ years of related claims experience, with recent background in a quality or compliance oversight role.
  • Skills: Strong oral and written communication skills, ability to evaluate, prioritize, and make informed decisions.
  • Certifications: Applicable claims, compliance, risk, and/or legal designations such as ARM, AIC, CRCMP, CLMP, ARC, CPCU, SCLA, or IRES desirable.

What We Offer

AmTrust Financial Services offers a competitive compensation package, including an estimated annual salary of $85,000 - $105,000 based on location and experience. Our benefits include medical & dental plans, life insurance, health care flexible spending, dependent care, 401k savings plans, and paid time off.

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