19 workers compensation claims examiner jobs found

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Senior Claims Examiner - WC .    The adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of worker’s compensation insurance claims through effective research, negotiation and interaction with insures, and claimants, ensuring that company resources are utilized in a cost-effective manner in the process. The adjuster reports to a WC Supervisor.  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...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote or hybrid position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic...

Overview Amtrust Financial Services, a fast growing commercial insurance company, has a need for a Workers’ Compensation Claims Manager.  The WC Claims Manager works with the Claim Adjusters to manage and ensure the Workers' Compensation claims activities are being handled within the Amtrust Best Practices, develop and maintain professional customer and broker relations by identifying and meeting customer needs.  Ensures that staff demonstrates customer service principles. Responsibilities Together with the Claim Supervisors and Manager develops short-range area plans and budget designed to achieve company goals and objectives. Secures, evaluates and develops staff   Ensures that staff works effectively as a team. Keeps the Claim Supervisors and Manager informed of current case status through regular communications and reports. Ensures that all AmTrust policies, procedures and controls are followed; also consults with...

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....

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This can be a hybrid or remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early return-to-work...

The Workers' Compensation Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This role can be hybrid or remote. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and...

The WC Medical Only Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This role can be hybrid or remote. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or...

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early return-to-work efforts with the appropriate parties...

The Senior WC Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior WC Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early return-to-work efforts...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. Essential Job Functions and Responsibilities Detects and prevents fraudulent claims through meticulous investigation and complex analysis. Analyzes and interprets data to identify...

Description At Liberty, you'll thrive in a hybrid setting that fosters in-person collaboration, innovation and growth. This approach optimizes both remote and in-person interactions, enabling you to connect and ideate with your team and deepen valuable relationships across the company, while still enjoying the flexibility of remote work for focused tasks and projects.   The Senior Claims Specialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior Claims Specialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical directions, and...

Description At Liberty, you'll thrive in a hybrid setting that fosters in-person collaboration, innovation and growth. This approach optimizes both remote and in-person interactions, enabling you to connect and ideate with your team and deepen valuable relationships across the company, while still enjoying the flexibility of remote work for focused tasks and projects.   The Senior Claims Specialist works within a Claims Team, using the latest technology to review, analyze and process claims that are routinely characterized as moderately complex to complex within assigned authority limits. This includes making decisions about liability/compensability, evaluating losses, negotiating settlements and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The Senior Claims Specialist may also assist the Claims Team Manager with assigning new claims to team members, providing technical directions, and...

The Claims Assistant will support the claims staff in the set-up and administration of workers’ compensation claims/case management and other tasks depending on the specific customer needs. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Sets up new claims Process mail, handle files (until paperless), and input notes/diary entries in the claims system Process payments, as needed Process form letters, state forms and reports Assist claims examiners with telephone calls including provider, claimant and customer calls Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent written and verbal communication skills PC literate, including Microsoft Office (Word, Excel) Ability to work independently and in a team environment Strong organizational skills   EDUCATION & EXPERIENCE:  High school diploma, college degree preferred Six (6) months of service oriented office...

Position Summary The Senior Underwriter for the D&O/Management Liability group is responsible for managing a portfolio of accounts and driving new and renewal business opportunities for Directors & Officers and Management Liability insurance. The role involves assessing risks associated with insuring management-related exposures, evaluating applications, analyzing data, and determining coverage terms and premiums to ensure sound underwriting decisions. They develop and maintain underwriting practices and guidelines per delegated authority and build strong relationships with brokers and other stakeholders in the designated portfolio. What will your job entail? Job Responsibilities: Underwrites new and renewal D&O and Management Liability business, analyzes policy forms, broker endorsement requests, and submitted documentation per company underwriting standards and guidelines, and obtains additional information as needed. Determines acceptance, modification,...

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary   The Arch Insurance Claims Division is seeking a VP, Casualty Claims to oversee the management and resolution of complex casualty claims across our commercial lines portfolio. This role is responsible for leading a team of claims professionals, ensuring high-quality claim handling, and driving strategic initiatives to improve outcomes for high-severity, complex general liability, auto, excess, and umbrella claims in jurisdictions throughout the United States.     Responsibilities   Specific duties include but are not limited to the below:   Provide technical expertise and oversight to a Casualty Claims...

Position Summary The Property and Casualty Underwriter is responsible for managing a portfolio of accounts and driving new and renewal business opportunities for Property and Casualty insurance. The role assesses risks associated with insuring properties and liabilities, evaluates applications, analyzes data, and determines coverage terms and premiums to ensure sound underwriting decisions. They develop and maintain underwriting practices and guidelines as per delegated authority and build relationships with brokers and other stakeholders in the designated portfolio. What will your job entail? Responsibilities: Underwrites new and renewal property and casualty business, analyzes policy forms, broker endorsement requests, and submitted documentation as per company underwriting standards and guidelines and obtains additional information as needed. Determines whether to accept, modify or decline a risk through evaluation of the coverage value, location, usage, safety...

Position Summary The Property and Casualty Underwriter is responsible for managing a portfolio of accounts and driving new and renewal business opportunities for Property and Casualty insurance. The role assesses risks associated with insuring properties and liabilities, evaluates applications, analyzes data, and determines coverage terms and premiums to ensure sound underwriting decisions. They develop and maintain underwriting practices and guidelines as per delegated authority and build relationships with brokers and other stakeholders in the designated portfolio. What will your job entail? Job Responsibilities: • Underwrites new and renewal property and casualty business, analyzes policy forms, broker endorsement requests, and submitted documentation as per company underwriting standards and guidelines and obtains additional information as needed. • Determines whether to accept, modify or decline a risk through evaluation of the coverage value, location, usage, safety...

Position Summary The Property Underwriter is responsible for managing a portfolio of accounts and driving new and renewal business opportunities for Property insurance. The role assesses risks associated with insuring properties and liabilities, evaluates applications, analyzes data, and determines coverage terms and premiums to ensure sound underwriting decisions. They develop and maintain underwriting practices and guidelines as per delegated authority and build relationships with brokers and other stakeholders in the designated portfolio.  What will your job entail? Job Responsibilities:   Underwrites new and renewal property business, analyzes policy forms, broker endorsement requests, and submitted documentation as per company underwriting standards and guidelines and obtains additional information as needed.     Determines whether to accept, modify or decline a risk through evaluation of the coverage value, location, usage,...