Claims Examiner, PIP
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Job Description
Claims Examiner analyzing complex Personal Injury Protection Claims and negotiating settlements. Role involves ensuring claims adjudication meets service expectations in a remote setting.
Responsibilities:
- Analyze complex or technically difficult Personal Injury Protection Claims to determine benefits due
- Work with high exposure claims involving litigation
- Ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements
- Identify subrogation of claims and negotiate settlements.
- Analyzes and processes complex or technically difficult third party property liability claims and personal injury protection claims by investigating and gathering information to determine the exposure on the claim
- Manages claims through well-developed action plans to an appropriate and timely resolution.
- Assesses liability and resolves claims within evaluation.
- Negotiates settlement of claims within designated authority.
- Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
- Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
Requirements:
- Bachelor's degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred
- Five (5) years of claims management experience or equivalent combination of education and experience required
- New York experience preferred but not required.
- Subject matter expert of appropriate insurance principles and laws for line-of-business handled
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Excellent negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Service Expectations.
Benefits:
- medical
- dental
- vision
- 401k and matching
- PTO
- disability and life insurance
- employee assistance
- flexible spending or health savings account
- other additional voluntary benefits
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