Program Claim Manager, Workers Compensation

Overview:

Amtrust Financial Services, a fast growing commercial insurance company, is seeking a Program Claims Manager. 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 years’ 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.

 

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.