Claims Adjuster, Medical Only

AmTrust North America

Job Description



Overview

The Worker’s Compensation Medical Only Claims Adjuster is responsible for the prompt and effective investigation of worker’s compensation claims involving injuries that require medical treatment but no wage loss. Claim adjudication requires interaction with Insureds, claimants, medical providers and other parties to ensure adequate medical treatment is provided while utilizing Company resources in a cost-effective manner.



Responsibilities

Responsibilities: 

  1. Ability to multitask and prioritize work in a fast-paced environment and manage time effectively
  2. Investigates losses of low to moderate severity to determine cause, scope and extent of injury and/or liability for potential subrogation
  3. Verifies coverage and confirms policy conditions have been met
  4. Obtains missing information and ensures data integrity for Regulatory reporting
  5. Communicates effectively with claimants, policyholders, Underwriters, agents, and other internal and external stakeholders
  6. Authorizes medical treatment and schedules medical appointments.
  7. Establishes medical reserves, approves medical bills and reviews/requests medical records
  8. Documents all correspondence, reports, discussions and decisions in Claim file notes
  9. Knowledge of multiple state jurisdictions (if applicable)
  10. Obtain appropriate Adjuster licensing (If applicable)
  11. Performs other related duties as assigned


Qualifications

Qualifications: 
Required

  • 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

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.

Job Requirements

 

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