AmTrust Financial Services

Program Claim Manager, Workers Compensation

AmTrust Financial Services$87K — $120K *
US-AnywhereRemote in United States
Finance & Insurance
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 7-10 years of experience in handling or litigating complex workers compensation claims.
  • Proficient in navigating a paperless claim filing system.
  • High level of technical claim and legal knowledge.
  • Excellent written and verbal communication skills.
  • Ability to interact effectively with diverse internal and external stakeholders.
  • Skilled in adapting to changing requirements.
  • Effective influencer and negotiator.
  • Texas designated home state adjuster license preferred; SCLA or CPCU designation/AIC certification preferred.

Responsibilities

  • Guide and motivate Third Party Administrators to improve performance.
  • Manage and oversee assigned claims accounts.
  • Conduct claim due diligence for new TPA/MGA partners.
  • Lead the implementation of new TPA programs.
  • Collaborate with data analytics to assess TPA performance and communicate findings.
  • Draft and update service instructions for claims programs.
  • Ensure compliance with regulatory reporting and best practices for TPA operations.
  • Identify and escalate service issues with TPAs and MGAs to senior management.
  • Evaluate coverage issues and risk transfer opportunities.
  • Oversee comprehensive investigations and select appropriate legal counsel as needed.

Benefits

  • Medical & Dental Plans for employees and eligible family members.
  • Life Insurance coverage for employees and their eligible spouses and children.
  • Health Care Flexible Spending Accounts (FSA).
  • Dependent Care Flexible Spending Accounts (FSA).
  • 401k Savings Plans with company matching.
  • Paid Time Off for work-life balance.
Full Job Description
Overview

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.

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
Qualifications
  • Minimum of 7-10 years9 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.
  • Texas designated home state adjuster license preferred.
  • SCLA or CPCU designation/AIC certification preferred.

The expected salary range for this role is $87,600- $120,000/year.

Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations.

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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.

About AmTrust Financial Services

AmTrust Financial Services, Inc. is a multinational property and casualty insurance company. The company provides coverage for small businesses, workers' compensation insurance, extended warranty coverage, specialty risk and extended warranty coverage, and other insurance products. AmTrust Financial Services, Inc. was founded in 1998 and is headquartered in New York City. The company is publicly traded on the NASDAQ stock exchange under the ticker symbol AFSI.
Learn more about AmTrust Financial Services
Size
8,000 employees
Industry
Founded
1998

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