Claims Examiner, Medical Only
Claims Examiner, Medical Only
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Overview
The Workers Compensation Medical Only Claims Examiner is responsible for the prompt and effective investigation of workers compensation claims involving injuries requiring medical treatment without lost wages. Claim adjudication requires interaction with employers claimants medical providers and other parties to ensure adequate medical treatment is provided utilizing company resources in a cost-effective manner.
Responsibilities
- Ability to multitask and prioritize work in a fast-paced environment and manage time effectively
- Investigates losses of low to moderate severity to determine cause scope and extent of injury and/or liability for potential subrogation
- Verifies coverage and confirms policy conditions have been met
- Obtains missing information and ensures data integrity for regulatory reporting
- Communicates effectively with claimants policyholders underwriters agents and other internal and external stakeholders
- Authorizes medical treatment and schedules medical appointments
- Establishes medical reserves approves medical bills and reviews/requests medical records
- Documents all correspondence reports discussions and decisions in claim file notes
- Knowledge of multi-state jurisdictions (if applicable)
- Obtain appropriate examiner licensing (if applicable)
- Performs other related duties as assigned
Qualifications
- Proficiency with MS Word Excel and other business applications
- Demonstrated skills in critical thinking and independent decision making
- State licensing requirements (if applicable)
Preferred:
- Minimum of 2 years handling Medical Only or other Workers Compensation claims experience
- Basic knowledge of medical conditions treatment plans and casual relation to occupational injury/illness
- Drive and desire to use this position as a starting point to potentially enter the Claim Associate training program and become a lost time adjuster in the future
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What We Offer
AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans Life Insurance including eligible spouses & children Health Care Flexible Spending Dependent Care 401k Savings Plans Paid Time Off.
AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard 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 sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative enabling us to attract retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company how we operate and how we see our future.
Employment Type
Full-Time
