9 workers compensation claims adjuster jobs found in Scottsdale

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.   This position is hybrid out of Scottsdale, AZ or remote in Arizona. Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively,...

Overview The Lead Claims Examiner is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of AmTrust and the Claims organization. Responsibilities Follows AmTrust policies and procedures in managing claims. Investigates the claim and coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured, claimant, witnesses and medical providers. Evaluates, establishes, maintains and adjusts reserves based on fact, company standard and experience. Skillfully negotiates claims, turning adverse perspectives into quick resolution. Gains trust of other parties to negotiations and demonstrates good sense of timing....

Overview Responsible for the prompt and efficient examination, investigation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds and claimants, ensuring that company resources are utilized in a cost effective manner in the process. Responsibilities Thoroughly investigating workers’ compensation claims by contacting injured workers, medical providers, and employer representatives. Determining if claims are valid under applicable workers’ comp statutes. Communicating with medical providers to develop and authorize appropriate treatment plans. Reviewing and analyzing medical bills to confirm charges and treatment are workers’ comp injury-related and in accordance with the treatment plan. Ensuring payments for medical bills and income replacement are remitted on a timely basis in accordance with applicable fee schedules and statute Answer questions...

Crum & Forster Company Overview Crum & Forster (C&F) provides market leading property & casualty, accident & health, specialty and standard commercial lines insurance solutions. A true underwriting company, we have a 200-year history of helping our customers manage risk with laser-focused expertise, integrity and discipline. Our people are empowered to make decisions and problem-solve with you smartly and swiftly. Our annual gross written premium is 6.2 billion. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best.   Our most valuable asset is our people. We have 3000 employees, and locations throughout the United States and India. With our employee-first focus, the Company is consistently recognized as a great place to work, earning multiple workplace and wellness awards, including the Great Place to Work® Award, Fortune 100 Best Companies to Work For, Fortune Best Workplaces for Parents, Fortune Best...

Overview AmTrust Financial Services is seeking a Director, Medical Case Management for the Western Zone. This senior leader will oversee approximately 40 clinical professionals, including four direct-report managers, and drive proactive, data-driven workers’ compensation medical case management performance, clinical quality, operational consistency, and claim outcomes in a fast-paced, high-change environment. Responsibilities Reporting to the Head of Managed Care and Clinical, the Director, Medical Case Management will lead Western Zone workers’ compensation medical case management operations to improve claim outcomes, return-to-work results, medical management impact, quality, compliance, and team performance. This role requires a proactive leader who combines strong clinical judgment with analytical discipline, using data, dashboards, trends, and performance insights to anticipate issues, identify opportunities, drive action,...

Overview AmTrust is a major player in the commercial P&C market and the third largest workers' compensation provider in the U.S. Our small business insurance product suite continues to expand with Cyber, BOP, Employment Practices Liability Insurance (EPLI), Package and other core coverages and capabilities, including more middle-market and large accounts.   As a Workers’ Compensation Claims Examiner Associate, you'll dive into investigating and resolving employee injury claims. You'll be the key link between injured workers, healthcare providers, employers, and legal teams, ensuring fair and efficient claim handling. Master examination by assessing liability through detailed evaluations, hone investigation skills by interviewing claimants and reviewing medical files and sharpen negotiation tactics for fair claim resolutions. Ultimately, you'll confidently settle claims using your investigative insights.   Note, this is an in-office opportunity out...

Crum & Forster Company Overview Crum & Forster (C&F) , with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.   Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work ® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.   C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.  For more information about Crum & Forster,...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has a need for a Clinical Pharmacist. Candidates located within a reasonable commuting distance of our South Jordan, Utah office will also be considered.   PRIMARY PURPOSE:  The Clinical Review Pharmacist has the responsibility of reviewing the medical necessity, appropriateness, and quality in the appropriate setting for workers’ compensation injured employee as it pertains to their medications. Additionally, they will work with Amtrust adjusters and nurses to take proper interventions in the care of the injured employee. This position primarily requires timely reviews of pharmacy prior authorizations to determine appropriateness and medical necessity of treatment. This position assesses the medical appropriateness of proposed medications for our injured employees and partners with the AmTrust claims team to expedite medically necessary treatment....

Overview The Transportation Liability Claim Representative is responsible for prompt efficient review and disposition of insurance claims through effective research, evaluation, investigation, negotiation and interaction with insureds or claimants. The Specialist is often, though not always, assigned to larger claims with a larger exposure or severity in the Line of Business. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust and Claims organization.   *This Role can be out of any AmTrust Office on a Hybrid Schedule* 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...