Claims Examiner II

San Diego, California
Not Specified
Oct 03, 2016
Dec 02, 2016
Job Type
Not Specified
Career Level
Not Specified

Title_Claims Examiner II_

About the OrganizationAmTrust Financial Services, Inc., (Nasdaq: AFSI) headquartered in New York City, is a multinational insurance holding company, which, through its insurance carriers, offers specialty property and casualty insurance products, including workers' compensation, commercial automobile and general liability; extended service and warranty coverage.

PositionWC Claims Examiner II

LocationCA, San Diego

DescriptionThe workers compensation claims adjuster is responsible for the prompt and efficient examination, investigation and settlement or declination of workers 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. Specifically, this position will handle workers comp claims for multiple states. Duties include but are not limited to:
  • Review, process and conclude high exposure liability claims or those limited in exposure but occasionally complex in nature
  • Oversee and direct a majority of litigated or potentially litigated claims, directing and controlling the work and expenses of investigative services or attorneys
  • Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud and resolution potential
  • Conduct a thorough analysis of liability and damages; continually assess exposure and evaluate for accurate reserves
  • Complete quality investigations by gathering all pertinent information (recorded statements, review of police and medical reports, photographs and appraisals/estimates of damages, etc.)
  • Determines if subrogation exists and takes steps necessary to initiate recovery efforts
  • Maintains appropriate financial accountabilities (reserving) and controls loss adjustment expenses
  • Fulfill state licensing agreements/requirements (if applicable) and apply knowledge of state laws and regulations pertaining to the insurance industry

    Open Date9/9/2016

    Position Requirements

    Position Requirements+ Ability to manage relationships in a fast paced environment, while demonstrating persistence along with problem solving and decision making skills to work with customers through a variety of challenging situations.
  • Good analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions.
  • Good knowledge of claim procedures, policies, technology, state and federal laws and insurance regulations.
  • Ability to multi-task and handle large volumes of work in a short period of time.
  • Ability to communicate effectively and clearly, both orally and in writing.
  • Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently and exhibit good common sense.
  • Ability to work independently with self-initiative.
  • Time management skills, organizational skills and ability to prioritize issues and tasks.
  • Ability to effectively operate computer equipment and applications.

    Education/Experience+ College degree is not a prerequisite for this position; however employee should possess such skills and knowledge as are normally gained in the successful completion of a four-year college program.
  • A valid California adjusters' license
  • Minimum of five years experience in workers compensation claims
  • Insurance coursework (e.g. IIA, CPCU, SCLA and AEI) is beneficial.
  • Good knowledge of insurance theory and practices; insurance contracts and their application.


    Req NumberCLA-16-00060


    Number of Openings1

    Employee Referral Eligible

    Employee Referral PayoutThis position is currently accepting applications.