What are the responsibilities and job description for the Technical Claims Specialist - Workers Compensation position at AmTrust Financial?
Technical Claims Specialist - Workers Compensation
Job Locations US-United States
Requisition ID
2023-15369
Category
Claims - Workers Compensation
Position Type
Regular Full-Time
Overview
AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Technical Claims Specialist in our Worker's Compensation Department.
Those within a 50-mile radius of an AmTrust office will be expected to abide by a hybrid work schedule.
Responsibilities
Drive claim quality improvement efforts and provide Technical Oversight on the Assigned Risk book of business.
- Responsibility for the Claims / Managed Care section of the NCCI Plan of Operation scorecard; understanding where our opportunities are and develop a plan of action to improve in those key areas.
- Coordinating the Claim portion of the annual NCCI bid response to ensure our responses are updated, accurate, achievable, succinct and that AmTrust puts its best foot forward in efforts to gain more business.
- Conduct informal file audits and claim reviews to identify issues and fix them in advance of formal audits.
- Ensuring claim and payment coding are accurate and in accordance with NCCI guidelines on Assigned Risk claims.
- Coordinate the Claim portion of the annual self-review audits and the Triannual audit; reviewing claims that are out of compliance and coordinate rebuttals when it's appropriate to do so.
- Developing and coordinating improvement plans based on audit findings.
- Keeping new claims on diary as needed to ensure the Adjuster met guidelines and timeframes as required by NCCI and that our standard claim handling practices are being adhered to.
- Coordinate with analytics to develop production reports and request ad hoc reporting to drive and measure the results of quality and compliance improvement opportunities.
- Develop, coordinate, and conduct training on requirements related to Assigned Risk claim handling.
- Coordinate with the Claim Modernization team on system changes that may be needed to better assist with the handling of Assigned Risk claims and unique requirements they may have.
- Position reports to the Head of Claim Technical, with a dotted line to the Zonal VP and Assigned Risk Office Lead.
Qualifications
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.
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