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Claim specialist jobs in New Jersey - 164 jobs

  • Claim Specialist

    Amtrust Financial 4.9company rating

    Claim specialist job in Jersey City, NJ

    Requisition ID JR1005075 Category Claims - Specialty Lines Type Regular Full-Time AmTrust Financial Services, a fast-growing commercial insurance company, is seeking an experienced Claims Specialist. This position can be located in one of our claims offices, with the possibility of working remotely. The successful candidate will directly handle both litigated and non-litigated commercial general liability claims. The successful candidate will also exhibit a strong proficiency in insurance coverage analysis and risk transfer. Responsibilities Managing an inventory of commercial general liability claims with moderate complexity by following company guidelines to manage all aspects of the claim handling, including coverage determinations, investigations, and strategic resolution plans which may include pursuit of risk transfer, negotiations, and litigation management. Recognizing potential exposures and ensuring reserving is appropriate and timely. Evaluating coverage issues and risk transfer opportunities. Ensuring appropriate investigation 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. Provide outstanding customer service and effectively communicate with our internal and external business partners. Formulate proper resolution strategies to ensure the best total claim outcome. Mentors less experienced Claim Professionals and may be asked to assist with special projects as needed. Position may require periodic travel to attend meditations, trials and/or other related meetings. Qualifications Minimum of five years of experience in the handling of litigated and non-litigated commercial general liability claims. Bachelor's degree or equivalent work experience. Strong contractual analysis skills to include the analysis of insurance contracts for coverage analysis and other contracts for risk transfer obligations/opportunities. Investigative mindset with critical thinking skills. Strong work ethic with organizational skills and the ability to work independently in a fast-paced environment. Knowledge of Microsoft Office and ability to learn business-related software. Excellent verbal and written communication skills with the ability to articulate claim facts, analysis and recommendations to leadership, business partners, and customers. Ability to partner with internal resources and oversee/manage outside counsel. Experience in leading negotiations, as well as developing and implementing strategic resolution plans. Adjuster licensing as required, with preference for Texas and/or Florida. The expected salary range for this role is $106k-$127k/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. #LI-EF1 #LI-Hybrid #AmTrust 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. Connect With Us! Not ready to apply? Connect with us for general consideration.
    $106k-127k yearly 2d ago
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  • Claims Representative, Auto Property Damage - Independent Agent Channel

    Plymouth Rock Assurance 4.7company rating

    Claim specialist job in Parsippany-Troy Hills, NJ

    The Auto Property Damage Claims Representative is responsible for managing Auto Property Damage claims within our “Auto PD Claim Unit.” This role demands a high level of customer service, patience, and professionalism while working in a fast-paced environment with significant phone interaction. Strong customer service, organizational, verbal, and written communication skills are essential. The ability to navigate adversarial situations with professionalism is critical. Comparative negligence claim handling experience is a plus but not required. RESPONSIBILITIES Policy Analysis: Investigate and interpret policy provisions, endorsements, and conditions to determine coverage for automobile property claims. Identify and investigate contested coverage claims that may require a roundtable discussion. Claim Investigation: Investigate auto accidents to assess liability by interviewing first- and third-party claimants, witnesses, investigating officers, and other relevant parties. Secure and analyze pertinent records, documentation, and loss scene information to determine proximate cause, negligence, and damages. Claims Management: Evaluate and adjust reserves as necessary. Prepare dispatch instructions for field personnel to inspect vehicles. Negotiate and settle claims within individual authority limits and seek supervisor approval for claims exceeding authority or requiring additional guidance. Maintain effective follow-up systems on pending files, advising insureds, claimants, and brokers on claim status. Act as an intermediary between the company, preferred vendors, and customers to resolve disputes. Ensure adherence to privacy guidelines, laws, and regulations in claims handling. Subrogation and Legal Handling: Investigate and initiate subrogation processes when applicable. Handle and respond to special civil part lawsuits or intercompany arbitrations related to auto property damage claims. Administrative Duties: Manage a customer-focused phone environment by answering calls, returning voicemails, and responding to emails and text correspondence promptly. Process incoming and outgoing mail timely and in accordance with state guidelines. Complete other duties as assigned. QUALIFICATIONS Bachelor's degree required. A minimum of 1 year of related PD claim experience is welcomed but not required. Proficiency in personal computer skills, including Microsoft Office Suite. Ability to prioritize and manage multiple tasks effectively. Excellent communication, organizational, and customer service skills. SALARY RANGE The pay range for this position is $47,000 to $55,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity. PERKS & BENEFITS 4 weeks accrued paid time off, 8 paid national holidays per year, and 2 floating holidays Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision) Annual 401(k) Employer Contribution Resources to promote Professional Development (LinkedIn Learning and licensure assistance) Robust health and wellness program and fitness reimbursements Various Paid Family leave options including Paid Parental Leave Tuition Reimbursement ABOUT THE COMPANY The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
    $47k-55k yearly 1d ago
  • Senior General Liability Claim Representative

    CWA Recruiting

    Claim specialist job in Union, NJ

    Senior General Liability Claim Representative - Property & Casualty Insurance Industry Union County NJ The management of accounts and the processing of claims related to litigated matters in hotels, real estate, hospitality, liquor liability, general liability, and bodily injury cases is a specialized function. This role necessitates an individual with a personality geared toward customer satisfaction. Responsibilities also include the negotiation of claims that are under litigation. Candidates should have at least 3 to 5 years of experience in handling middle market claims and possess a college degree. A valid New York adjuster's license is essential, while licenses from other states are considered a plus.
    $48k-70k yearly est. 1d ago
  • Claims Adjuster

    DOWC

    Claim specialist job in Parsippany-Troy Hills, NJ

    About Us Dealer Owned Warranty Company LLC is a leading provider of F&I (Finance and Insurance) partnership services in the automotive industry, offering a full suite of obligor and administrator services, top-of-the-line products, technology, and training. We understand the importance of leveraging process and technology in the F&I industry to drive revenue and ensure success. Our goal is to provide visibility, transparency, and the tools needed for our partners to build their wealth and achieve their goals. DOWC prides itself on taking care of its employees (We were voted one of the “Best Places to Work” three years in a row!), and we also offer award-winning products. All of our positions are fully on-site in Parsippany, NJ. Overview We are seeking a dedicated and motivated Claims Representative to join our dynamic team. This role is essential in providing exceptional customer support to our contract holders related to warranty claims. The ideal candidate will possess strong communication skills, professional phone etiquette, a keen attention to detail, a love for customer service, excellent problem resolution, and the ability to work effectively in a fast-paced and high-volume environment. This person will be solution-oriented and eager to learn a complex business. Opportunities for advancement within the department with training provided. Job Duties: Provide outstanding customer support via phone, email, and chat related to claims inquiries. Handle a high volume of inbound calls with a minimum of 40 calls answered per day. Assist contract holders with inquiries regarding products and services, ensuring a high level of satisfaction pertaining to our contract guidelines. Accurately log and track customer issues, inquiries, and requests in the incident management system from identification through resolution. Deliver timely and reliable roadside assistance to customers in need. Process payments accurately and efficiently to ensure a smooth customer experience. Communicate effectively with team members and customers to resolve issues promptly. Adjudicate simple claims and troubleshoot basic to intermediate product or service issues. Connect and triage customers calling in for a claim with the appropriate mechanical claims analysts. Demonstrate excellent phone etiquette while handling client interactions. Collaborate internal departments to streamline customer services with adherence to SLAs. Maintain a queue of ongoing support tasks and resolve all customer issues in a high-priority manner. Proactively communicate with leadership to escalate any issues for immediate resolution. Create a positive support experience through active listening, problem-solving, and professional communication. Analyze information and process documents to resolve issues prior to escalation. Develop product knowledge to become a subject matter expert and confidently address customer concerns. Participate in further training sessions to enhance product knowledge and service skills. Qualifications Minimum of 2+ years as a claims adjuster or role in a customer service/call center environment. Proven experience handling a high volume of inbound customer calls. Insurance claims or automotive industry highly preferred. Ability to resolve escalated issues with a sense of urgency. Strong business acumen with the ability to identify customer needs and recommend appropriate solutions. Excellent communication skills, both verbal and written. Proficiency in data entry and familiarity with MS office software applications. Ability to work independently as well as part of a team in a collaborative environment. Strong organizational skills with an emphasis on attention to detail. Superior sense of urgency and ability to complete tasks in a timely manner. Strong customer-first attitude and relationship building skills. Come join our growing team here in Parsippany! As NJ's Best Places to Work Honoree for three years in a row, we offer: Competitive compensation Medical, Dental, Vision, 401k matching, Life Insurance, medical expense card PTO and Sick Time Corporate events, team and culture building activities, employee awards and recognition, company trips and more! DOWC is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected Veteran status, sexual orientation, gender identity, gender expression, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact us for assistance.
    $53k-69k yearly est. 16h ago
  • RI Accounting & Claims Handling Analyst

    Munich Re 4.9company rating

    Claim specialist job in Princeton, NJ

    We are adding to our diverse team of experts and are looking to hire those who are committed to building a culture that enables the creation of innovative solutions for our business units and clients. The Company Munich Re America Services (MRAS) is a shared service organization that delivers services to all Munich Re US P&C Companies and other group entities. As a member of Munich Re's US operations, we offer the financial strength and stability that comes with being part of the world's preeminent insurance and reinsurance brand. Our risk experts work together to assemble the right mix of products and services to help our clients stay competitive - from traditional reinsurance coverages, to niche and specialty reinsurance and insurance products. The Opportunity Future focused and always one step ahead! The Reinsurance Accounting & Claims Handling Analyst is responsible for the timely and accurate recording of client company contract, premium and loss related information into the Company's global reinsurance systems. Requires the ability to work with and analyze client reported data received in various levels of detail and formats. Responsibilities Responsibilities for this role will primarily focus on handling the following accounting related tasks with guidance and in accordance with agreed upon best practices, policies and procedures, and/or service level agreements: Record client account statements in a timely and accurate manner Investigate and resolve open payable/receivable balances Prepare result dependent condition calculations Processing payment transactions (incoming and outgoing) in accordance with contract terms Accurately capture terms and conditions into global systems with guidance Resolve quality assurance tasks or questions Research and reconcile accounting matters related to statements of account Participate in quarter close process Participate in projects when needed Qualifications Successful candidates will possess the following skills/capabilities: Bookkeeping and/or accounting experience Associates or Bachelor's Degree, preferably in Accounting, Finance, Mathematics, Computer Science, Data Science/Analytics or equivalent experience. Strong attention to detail, time management and decision-making skills Interpersonal skills including verbal and written communication, relationships and teamwork Solid math and analytic skills Proficiency with Microsoft Office (Outlook, Word, Excel) which includes the ability to learn new and complex computer system applications. Data manipulation and analysis. Excel required. The Company is open to considering candidates in Princeton, NJ. The salary range posted below applies to the Company's Princeton location. The base salary anticipated for this position is $56,000. plus opportunity for company bonus based upon a percentage of eligible pay. In addition, the company makes available a variety of benefits to employees, including health insurance coverage, an employee wellness program, life and disability insurance, 401k match, retirement savings plan, paid holidays and paid time off (PTO). The salary estimate displayed represents the typical salary range for candidates hired in this position in Princeton, NJ. Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have and comparison to other employees already in this role. Most candidates will start in the bottom half of the range. We are proud to offer our employees, their domestic partners, and their children, a wide range of insurance benefits: Two options for your health insurance plan (PPO or High Deductible). Prescription drug coverage (included in your health insurance plan). Vision and dental insurance plans. Additional insurance coverages provided at no cost to you, such as basic life insurance equal to 1x annual salary and AD&D coverage that is equal to 1x annual salary. Short and Long Term Disability coverage. Supplemental Life and AD&D plans that you can purchase for yourself and dependents (includes Spouse/domestic partner and children). Voluntary Benefit plans that supplement your health and life insurance plans (Accident, Critical Illness and Hospital Indemnity). In addition to the above insurance offerings, our employees also enjoy: A robust 401k plan with up to a 5% employer match A retirement savings plan that is 100% company funded. Paid time off that begins with 24 days each year, with more days added when you celebrate milestone service anniversaries. Eligibility to receive a yearly bonus as a Munich Re employee. A variety of health and wellness programs provided at no cost. Paid time off for eligible family care needs. Tuition assistance and educational achievement bonuses. A corporate matching gifts program that further enhances your charitable donation. Paid time off to volunteer in your community. At Munich Re, we see Diversity, Equity and Inclusion as a solution to the challenges and opportunities all around us. Our goal is to foster an inclusive culture and build a workforce that reflects the customers we serve and the communities in which we live and work. We strive to provide a workplace where all of our colleagues feel respected, valued and empowered to achieve their very best every day. We recruit and develop talent with a focus on providing our customers the most innovative products and services. We are an equal opportunity employer. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. #LI-MB1 Apply Now Save job
    $56k yearly 1d ago
  • Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations

    Stout 4.2company rating

    Claim specialist job in Edison, NJ

    At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include: Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations. Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies. Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic. Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning. Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives. Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support. Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations. Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery. Continue developing technical, analytical, and consulting skills while building credibility with clients. Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement. Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team. What You Bring Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred. Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles. Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance. Epic Resolute or other hospital billing system experience preferred; Epic certification a plus. Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required. Additional certifications such as CHC, CFE, or AHFI preferred. Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization. Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred. Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act. Willingness to travel up to 25%, based on client and project needs. How You'll Thrive Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions. Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships. Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time. Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment. Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility. Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success. en/careers/benefits The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.
    $41k-50k yearly est. 2d ago
  • Commercial Insurance Specialist

    Colonial Surety Company

    Claim specialist job in Woodcliff Lake, NJ

    We are seeking a motivated and knowledgeable Commercial Insurance Specialist to join our business insurance team. This role is responsible for advising commercial clients on insurance products, quoting and binding policies, servicing accounts, and ensuring customer satisfaction. The ideal candidate has a strong understanding of P&C insurance products and thrives in a fast-paced, client-focused environment. Key Responsibilities: Develop and maintain relationships with commercial clients, ensuring their property and casualty insurance questions are answered. Provide quotes, online policy insurance policies, and process endorsements, renewals, and cancellations. Respond to client inquiries and follow up to ensure excellent customer service and retention. Stay current on products, underwriting guidelines, and regulatory requirements. Maintain accurate records in the CRM and agency management systems. Requirements: 2+ years of experience in commercial property and casualty insurance preferred. Active P&C insurance license is a bonus Strong phone skills Familiarity with small and mid-size business insurance products and rating tools. Strong communication and customer service skills. Ability to multitask, manage priorities, and meet deadlines. Ability to commute daily to our Woodcliff Lake, NJ office is required. This is an in-office position, Monday through Friday, from 8:30 AM to 5:30 PM. Business attire and a clean-shaven appearance are required each day. Preferred Qualifications: Experience working in an independent agency or with a direct writer. Bilingual abilities are a plus. Bachelor's degree or equivalent professional experience.
    $30k-40k yearly est. 3d ago
  • Claims Specialist

    Berkley 4.3company rating

    Claim specialist job in New Jersey

    Company Details Berkley Luxury Group is an operating unit of W.R. Berkley Corporation, one of America's largest commercial lines writers in the United states. At Berkley Luxury Group we offer tailored, all-inclusive insurance solutions for luxury condo, co-op, rental properties and fine dining restaurants. Berkley Luxury Group has been a mainstay in the commercial real estate and hospitality business since 1986. We specialize in luxury condominiums, cooperatives, and apartments in the habitational space, Class A Office buildings and fine dining restaurants in the hospitality space. BLG maintains a standard of prompt and fair settlement of claims, and endeavors to treat insureds and brokers in a partnership-like manner. BLG has developed a strategic plan to grow their success by expanding their footprint geographically and adding complementary products. At BLG there is a shared vision to be the best option for its customers. We aim to provide comprehensive insurance solutions, use enhanced data and technology to make more informed decisions and rely on a field-based underwriting, claims and loss control model to be closer to our customers and brokers. Our goal is to provide superior services and products to these unique businesses. At Berkley Luxury Group, our employees are our most important asset. We recognize that if we properly support and develop our employees, they will become our primary sustainable competitive advantage and the key to achieving success. As such, we have created a high performing culture incorporating our values into work practices, policies, and processes to foster, reinforce and sustain an environment where employees share a strong sense of purpose, commitment, and motivation to meet and exceed their goals. As a Berkley company, we enjoy operational flexibility that allows us to deliver quality coverage solutions. W. R. Berkley Corporation, and all member insurance companies, are rated A+ (Superior) by A.M. Best Company and carry Standard & Poor's Financial Rating of A+ (Strong). The company is an equal opportunity employer. Responsibilities Berkley Luxury is seeking a Senior Claims Specialist to join our team! This role is located is our new Parsippany NJ office. As a Claim Specialist, you will manage a wide range of commercial lines casualty claims, focusing on developing and implementing effective resolution strategies while delivering exceptional customer service. In this role, you will ensure high-quality claims handling through investigation, accurate analysis of coverage and liability, precise damage assessment, and resolution of claims, including those in litigation. As a key member of the casualty team, you will also help foster a culture of accountability, collaboration, continuous learning, and proactive performance improvement-contributing to both departmental excellence and the overall success of the company. Conduct thorough investigation and expert analysis of claims facts to determine coverage, liability, and applies appropriate legal concepts to evaluate damages and recommend appropriate course of action. Analyze and interpret policy language and case law in conjunction with specific loss facts to reach appropriate coverage decisions and write appropriate coverage correspondence in compliance with state statutes and regulations. Demonstrate a strong sense of urgency in promptly conducting comprehensive claims investigations to assess damages and liability, establish accurate reserves, and actively pursue timely and appropriate resolutions. Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposures, risk transfer, reserve adjustments, coverage issues, and claim resolution strategies. Resolve claims through negotiation, mediation, and arbitration with minimal assistance. Address inquiries from brokers and policyholders and provide superior customer service. Attend and participate in industry related conferences, seminars, and webinars and demonstrating a personal commitment to professional development. Ensure claims handling compliance and alignment with insurance regulations and Company policies. May participate in projects and other corporate initiatives such as audits, task forces, focus groups, etc. Other duties as required. Qualifications Education Bachelor's degree or equivalent experience JD degree a plus Experience 5-7 years of experience handling commercial general liability claims. Experience managing litigated claims and working with defense counsel. Proven track record of effective claims resolution and negotiation. Technical Skills Strong knowledge of claims investigation techniques, liability assessment, and damage evaluation. Demonstrated expertise in legal processes and litigation management. Ability to interpret and apply policy language accurately. Analytical & Decision-Making Demonstrated critical thinking and sound judgment in analyzing claims. Advanced analytical abilities to evaluate liability, quantify damages, and determine exposure. Proven capacity to make prompt, well-reasoned, and evidence-based decisions. Communication & Interpersonal Excellent written, verbal, and presentation communication skills. Effective communicator with diverse stakeholders, including policyholders, claimants, attorneys, and internal teams. Strong negotiation skills Organizational & Time Management Strong organizational skills with attention to detail. Effectively manages priorities and meets deadlines in a fast- paced environment. Team & Culture Fit Takes ownership, shows initiative, and approaches problem-solving with a proactive mindset. Collaborative team player dedicated to achieving shared goals. Committed to continuous improvement and ongoing professional development. Supports and upholds the company's commitment to equal employment opportunity. Additional Company Details The company is an equal opportunity employer. We do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role includes: Base Salary Range: $83,000 - $156,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Eligible to participate in the annual discretionary bonus program. Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. Sponsorship Details Sponsorship not Offered for this Role Not ready to apply? Connect with us for general consideration.
    $83k-156k yearly Auto-Apply 38d ago
  • Claims Examiner II (PIP)

    Athens Administrators 4.0company rating

    Claim specialist job in Parsippany-Troy Hills, NJ

    DETAILS Claims Examiner II - PIP Department: Property & Casualty Reports To: Claims Supervisor P&C FLSA Status: Exempt in all states but CA Job Grade: 11 Career Ladder Next step in progression could include Senior Claims Examiner ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Claims Examiner II to support our Property & Casualty department. Employees who live less than 26 miles from the Concord, CA, Orange, CA, San Antonio, TX, or Lake Mary, FL offices are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in a state Athens operates in (includes CA, CT, FL, GA, ID, IL, MA, NY, NC, NJ, OH, OK, OR, PA, SC, TN, TX, VA and WV). Athens Program Insurance Services is the centerpiece of P&C claims administration in the specialty programs marketplace. We are totally unique in that we focus only on commercial business specialization across multiple coverage lines. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday through Friday at 37.5 hours per week. As an Inside Property and Casualty Claims Examiner II, this candidate will be responsible for the review, analysis, and process of moderate to severe no-fault auto liability claims with an opportunity to handle Commercial Property, Inland Marine, and General Liability claims. These claims are typically moderate exposure and may entail litigation and coverage issues. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Advanced knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, 2) functional knowledge of law and insurance regulations in various jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills. Investigate, evaluate, and determine settlement value of moderate level PIP commercial auto claims Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management Manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure. Ensure appropriateness of all payments Coordinate and work with a vendor service such as appraiser, independent adjusting firms, contractors, social media and private investigation and various other field service vendors Facilitate between claimants, clients, brokers, and attorneys in resolution of liability claims Exchange information with clients, claimants, insurance brokers, inspectors, producers, and account managers Attend meetings and educational seminars for professional development Maintain required licenses Conduct quarterly claim reviews with the client ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX, or FL Additional State Adjuster License(s) may be required within 180 days Maintain licenses and continuing education requirements in all states. Minimum of 5 years PIP claims handling experience NY PIP experience preferred Knowledge regarding the handling and resolutions of arbitrations relating to New York PIP Knowledge of laws and regulations regarding PIP in multiple jurisdictions. Primary jurisdictions would be NY, FL, and NJ Knowledge of tort law, civil procedure, and contract law Knowledge of auto insurance laws, codes, procedures, and liability concepts Knowledge of property and casualty insurance policies Negotiation skills Relies on extensive experience and judgment to plan and accomplish goals in a fast-paced environment Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor. Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Must be able to reliably commute to meetings and events as required by this position APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************** This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here
    $51k-77k yearly est. 60d+ ago
  • Complex Casualty Claims Specialist - MidAtlantic Region

    Liberty Mutual 4.5company rating

    Claim specialist job in Marlton, NJ

    Join Our Team as a Senior Claims Resolution Specialist - MidAtlantic Region Are you ready to take your claims expertise to the next level? Personal Lines Casualty Complex is seeking a dedicated and experienced Senior Claims Resolution Specialist to lead the handling of challenging auto and homeowner's casualty claims across our MidAtlantic Region. In this pivotal role, you'll take ownership of complex, high-exposure cases, diving deep into investigations, evaluations, and strategic resolutions. This is your opportunity to make a real impact, handling severe and catastrophic injury claims that demand both skill and compassion. If you thrive in a fast-paced environment where your expertise drives meaningful outcomes, we want to hear from you! Preference for candidates who reside within Eastern or Central Time Zones. There is an in-office requirement twice a month if you live within 50 miles of one of our Hub locations. 10% travel may be required for mediations, arbitrations, trials and in-person events. Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory. Responsibilities: Manages, investigates, and resolves auto and homeowner's casualty claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed procedures and authority. Recommends ultimate resolution on assigned cases in excess of their authority to local claims management and Home Office. Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status. Confers with trial counsel and prepares trial reports. Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. Responds to various written and telephone inquiries including status reports. Ensures adequacy of reserves. Recommends reserve increases on cases in excess of authority. Accountable for security of financial processing of claims, as well as security information contained in claims files. Responsible for managing the practices and billing activities of outside and in-house counsel. May assist in the absence of the Claims Team Manager, representing the company on matters involving state or federal regulatory agencies. May be involved in special projects and/or mentoring at the direction of local management. Ideal experience includes: 5+ years of casualty and litigation experience Expert knowledge of handling personal lines complex claims with severe to catastrophic injuries and fatalities Qualifications Must have an advanced knowledge of coverage, liability, and complex claims handling procedures. Must be knowledgeable of state and federal laws in the adjuster's jurisdiction. A full working knowledge of claims operations and procedures is required. Strong written and oral communication skills required as well as strong interpersonal, analytical, investigative, and negotiation skills. The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree or equivalent experience and at least 5-7 years of directly related experience. Ability to obtain proper licensing as required. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.
    $86k-117k yearly est. Auto-Apply 16d ago
  • Claims Examiner

    Harriscomputer

    Claim specialist job in New Jersey

    Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.
    $36k-66k yearly est. Auto-Apply 34d ago
  • Claims Examiner - Binding Authority

    Coaction Specialty Insurance Group

    Claim specialist job in Morristown, NJ

    At Coaction, we're a unique mix of leaders, achievers, thinkers, and team players with a high-performance mindset and a diverse skillset. We bring our industry expertise together to continually push the boundaries of what insurance can be for our clients. If you are looking for a career in the insurance industry this could be the right role for you! Coaction is looking for talented and driven candidates who combine strategic thinking, creativity, and pragmatic execution to drive business results. This is an exciting opportunity to join our organization as a Senior Claims Examiner. We are looking for motivated individuals who will contribute to our team and perform under strict timelines. Responsibilities: Provide expert claim handling in areas of coverage, investigation, evaluation, and resolution of complex third-party bodily injury and property damage claims. Ability to comport with best practices in claims handling by timely investigating and evaluating on liability and damages. Ability to analyze policies and review relevant contracts to explore risk transfer strategies and priority of coverage. Draft appropriate coverage position letters. Set timely indemnity reserves after conducting thorough investigation and evaluation on liability and damages. Proactive approach towards negotiating claims towards resolution. Manage expense reserves and engage in resolution strategies to obtain cost effective results. Provide excellent customer service to insureds and brokers and timely advise underwriting of various losses. May be called upon to perform other tasks and duties within the claims department as dictated by business needs. Qualifications Solid planning & organizational skills including time-management and prioritization. 2+ years of claims handling experience primarily handling general liability claims. Must be willing to obtain adjuster's license in all states requiring licensure. Must be willing to occasionally travel. **This is not a fully remote position. Applicants must sit in our Morristown, NJ office on our hybrid work schedule.** Salary range specific to for this role : $60,000-$97,000 + discretionary incentive bonus + benefits depends on various factors including, without limitation, individual and organizational performance. The offered rate of compensation will be based on individual education, experience, and qualifications. In addition, employees are eligible for standard benefits package including paid time off, medical, dental and retirement. Equal Opportunity Employer Coaction is an Equal Employment Opportunity employer. Coaction's policy is not to discriminate against any applicant or employee based on race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, and genetic information, or any other basis protected by applicable law. Coaction also prohibits harassment of applicants or employees based on any of these protected categories. If your application is selected, you will receive an email directly from the Coaction Recruiting Team at ********************** asking you to contact a member of the Coaction Recruiting Team. Any other method of contact may be fraudulent.
    $60k-97k yearly Auto-Apply 60d+ ago
  • Claims Specialist 3- Staffing

    Circet USA

    Claim specialist job in Englewood Cliffs, NJ

    Job Description Circet USA is the leading provider of Network Services in North America, and we're looking for talented professionals to join our team. We specialize in engineering and construction services delivering comprehensive solutions across Inside Plant, Outside Plant, and Wireless networks to meet the evolving infrastructure needs of our customers. With nearly 50 years of industry experience, we work with major telecom service providers, MSOs, cloud service providers, and utilities. At Circet USA, you'll have the opportunity to make an impact by helping to create customized solutions that address our clients' unique challenges. If you're passionate about innovation and thrive in a dynamic environment, we'd love to hear from you. Circet USA's benefits package includes the following: Medical, Dental, and Vision insurance Digital Health & Wellness Support Critical Illness, Accident, & Hospital Insurance Short-term & Long-term disability Group term & Voluntary life insurance Flexible Spending and Health Savings Accounts Paid Time Off & 401K Company Discount Website Responsibilities We are seeking a highly skilled and experienced Claims Specialist 3 to fulfill a staff augmentation role with Circet USA's customer. The primary objective of the Claims Specialist is to support Product Safety/Product Liability Department with operational activities including Direct Claim handling, customer contact & admin support, and overall claims management. The goal of the Claims Specialist is to support the Product Safety Team by handling Claims with professionalism, care and urgency, making sure claims are reported and being handled in a timely manner. To achieve the highest performance, the person in this position is expected to maintain effective and timely communication with key customers, claims adjusters, stakeholders and leaders within the department, team, and cross-department where applicable. ESSENTIAL DUTIES & RESPONSIBILITIES include the following. Other duties may be assigned: Collaborate with team members in the Product Safety department, PL Insurance Carrier, outside law firm and 3rd Party administrators. Generate daily/weekly/monthly reports, with analysis and recommendations Manage 4-7 ongoing and ad-hoc projects that may include KPIs and Metrics Ensure that all projects have required documentation as they move through the project tollgates Communicate to Product Liability leadership on project status and escalation/decision points Works cross functionally with HQ teams in Korea (occasional evening conference call) and SEA operations to manage all possible risks. Pending Claim Management, KPI & TAT Management - Claim registration to closure Product Verification Liability Assessment by reviewing diagnosis results Reporting on high-profile claims to the leadership Qualifications Bachelor's Degree (or equivalent experience) 3-5 years of hands-on claims management & customer care experience Expertise in MS, Excel, and PPT Proven capability to analyze data and develop a course of action Proven ability to prioritize and manage multiple projects, meet deadlines and drive to resolution Process, procedure, strategic planning and project development experience Experience working with and influencing cross-functional teams. Experience working within the insurance and/or home appliance industry a plus Experience with product development or testing a plus Experience working in a complex and wide organization and department Claims Adjuster License a plus Takes project ownership and possess leadership qualities with an entrepreneurial approach Circet USA is an Equal Opportunity Employer - Veteran/Disabled. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by law.
    $44k-79k yearly est. 23d ago
  • Claims Specialist

    Sales Match

    Claim specialist job in Newark, NJ

    Job Title: Remote Claims Specialist Hourly Pay: $22 -$27/hour We are looking for a skilled Claims Specialist to join our work-from-home team. In this role, you will assist in processing and reviewing insurance claims, ensuring all necessary information is gathered, and helping resolve claims efficiently. If you have strong attention to detail and enjoy supporting customers through the claims process, this is a great opportunity for you. Key Responsibilities: Assist in processing insurance claims, ensuring accuracy and timely resolution Review claims documentation, including reports, medical records, and other evidence Communicate with claimants, insurance adjusters, and third parties to gather information Help resolve disputes or issues with claims and escalate when necessary Maintain detailed records of claims progress and updates Ensure compliance with industry regulations and internal policies Provide excellent customer service and answer inquiries related to claims Qualifications: Experience in insurance, claims handling, or a related field Strong attention to detail and organizational skills Excellent communication and customer service abilities Ability to handle multiple claims and prioritize effectively in a remote environment Familiarity with insurance policies and claims procedures is a plus Must have reliable internet and a quiet, dedicated workspace Perks & Benefits: 100% remote work flexibility Competitive hourly pay: $22 - $27 Paid training and professional development opportunities Flexible work hours, including evening and weekend options Opportunities for career growth in the insurance industry A supportive and team-oriented work environment
    $22-27 hourly 60d+ ago
  • Litigation Claims Specialist

    Questor Consultants, Inc.

    Claim specialist job in Deptford, NJ

    Job DescriptionRisk Intermediary located in New Jersey seeks a VP of Claims for a Municipal Insurance fund. Claims handled are Workers Comp, Property and Liability and Professional Liability. Fund has 28 members submitting New Jersey based Public Entity based claims. This position will lead operational and administrative claims functions including reserving. Will also manage TPA relationships and direct TPA's Workers Comp activities. Will also manage staff Liability Litigation Managers and lead claims reporting. Require JD with 20 years experience in an Insurance Claims Department, TPA or Risk Management Department. Knowledge of New Jersey Civil Tort and Workers Comp claims systems. Advanced skills in Coverage Analysis, Litigation Management and Negotiation. Auto Liability, General Liability and Employer Liability claims. Knowledge needed in MS Office Products (Word, Excel and Powerpoint). Will work remote but must be within driving distance of office. Will manage 9-12 people. Minimal travel. Salary $150-200k no bonus opportunity.
    $45k-80k yearly est. 25d ago
  • Auto Claim Representative, I

    Travelers Insurance Company 4.4company rating

    Claim specialist job in Morristown, NJ

    **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $55,200.00 - $91,100.00 **Target Openings** 4 **What Is the Opportunity?** This role is eligible for a sign on bonus up to $10,000 Be the Hero in Someone's Story When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process. **What Will You Do?** + Provide quality claim handling of Auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations. + Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates. + Determine claim eligibility, coverage, liability, and settlement amounts. + Ensure accurate and complete documentation of claim files and transactions. + Identify and escalate potential fraud or complex claims for further investigation. + Coordinate with internal teams such as investigators, legal, and customer service, as needed. + Insurance License: In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. **What Will Our Ideal Candidate Have?** + Bachelor's Degree. + Three years of experience in insurance claims, preferably Auto claims. + Experience with claims management and software systems. + Strong understanding of insurance principles, terminology with the ability to understand and articulate policies. + Strong analytical and problem-solving skills. + Proven ability to handle complex claims and negotiate settlements. + Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants. **What is a Must Have?** + High School Diploma or GED required. + A minimum of one year previous Auto claim handling experience or successful completion of Travelers Auto Claim Representative training program is required. **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .
    $55.2k-91.1k yearly 60d+ ago
  • Claims Examiner, Commercial Insurance

    Archgroup

    Claim specialist job in Jersey City, NJ

    With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary Arch Insurance Group Inc., AIGI, has an opening with the Claims Division as a Claims Examiner, Casualty. In this role, the responsibilities include actively managing medium-high severity commercial liability claims in jurisdictions throughout the United States. Responsibilities Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary Investigate claims and review the insureds' materials, pleadings, and other relevant documents Identify and review each jurisdiction's applicable statutes, rules, and case law Review litigation materials including depositions and expert's reports Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues Retain counsel when necessary and direct counsel in accordance with resolution strategy Analyze coverage, liability and damages for purposes of assessing and recommending reserves Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter Negotiate resolution of claims Select and utilize structure brokers Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines Strong time management and organizational skills Demonstrated ability to take part in active strategic discussions Demonstrated ability to work well independently and in a team environment Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word Willing and able to travel 10% Hybrid schedule, 3 days a week in office Education Bachelor's degree required. Minimum of 3 years of working experience with a primary and or excess carrier supporting commercial accounts for Casualty claims Proper & active adjuster licensing in all applicable states #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $95,000 - $150,000/year based on experience level Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
    $36k-66k yearly est. Auto-Apply 15d ago
  • Associate Claims Examiner

    Markel 4.8company rating

    Claim specialist job in Red Bank, NJ

    What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills. Associate Claims Examiner will be responsible for the resolution of claims with the Prompt Resolution Team (PRT) of lower complexity and exposure. This position will have decision-making authority in the amount of $25,000 and work under the general direction of their manager. The ACE position supports all product lines in Casualty with particular emphasis on Binding and Commercial Wholesale Primary and Small Commercial Programs. Job Responsibilities Confirms coverage of claims by reviewing policies and documents submitted in support of claims. Conducts, coordinates and directs investigation into loss facts and extent of damages. Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure. Strong emphasis on customer service to both internal and external customers is a major focus for the ACE as this role will handle small commercial claims that require excellent customer service to insureds and agents. Set reserves within authority (up to $25,000) and resolve claims within a prompt timeframe avoiding expense relating to independent adjusting. Required Qualifications Must have or be eligible to receive claims adjuster license. Successful completion of basic insurance courses or achievement of industry designations. Ability to be trained in insurance adjusting up to two years of claims experience. 2-4 years of experience in general liability, construction defect, or related liability lines preferred. Bachelor's degree preferred Excellent written and oral communication skills. Strong organizational and time management skills. # LI-Hybrid US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Pay information: The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The salary for the position is $25 - $38.25 with a 10% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose ‘Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.
    $49k-72k yearly est. Auto-Apply 60d+ ago
  • PIP Appeal and Litigation Adjuster

    NJM Insurance Group 4.7company rating

    Claim specialist job in Hammonton, NJ

    NJM's General Claims Legal department is seeking a PIP Appeal and Litigation (PAL) Adjuster who will be responsible for conducting a complete and thorough investigation on assigned claims and manage those claims through their life cycle. Job Responsibilities: Review, evaluate and process incoming Pre-Litigation Appeals in accordance with the PIP Internal Appeal Procedures. Review, manage and update litigated files to maximize litigation resources and ensure legal outcomes consistent with NJM litigation strategy. Evaluate and process all claims, settlements and awards consistent with the proper regulatory, statutory and NJM guidelines for the governing time periods. Communicate timely and effectively with defense counsel in preparing for trial/arbitration and attend legal proceedings as appropriate. Collaborate and communicate cross-departmentally regarding claims and appeals handling related to pending litigation. Required Skills & Qualifications: Minimum 3 years' experience working in a previous role dealing with PIP Regulations and Statutes Arbitration experience is a plus Must have strong attention to detail and ability to read, analyze and assess data Strong written and verbal communication skills Must be open to change and be able to rapidly adapt to new information or unexpected obstacles. Must be able to demonstrate strong problem-solving skills and the ability to make sound decisions Ability to multi-task Bachelor's Degree is a plus but not required Proficient skills in Microsoft, Word, Excel and Outlook. Working knowledge of all or any of the following is a plus: Guidewire Claim Center, Mitchell Decision Point, OnBase Unity Client, Agile Point Compensation: This role may be filled at PAL Adjuster, or PAL Adjuster, Senior level based on skills, experience and credentials. PAL Adjuster: $59,744 - $75,360 PAL Adjuster, Sr: $79,129 - $91,833 Compensation: Salary is commensurate with experience and credentials. Pay Range: $61,256-$77,255 Eligible full-time employees receive a competitive Total Rewards package, including but not limited to a 401(k) with employer match up to 8% and additional service-based contributions, Health, Dental, and Vision insurance, Life and Disability coverage, generous PTO, Paid Sick Leave, and paid parental leave in addition to state-mandated leave. Employees may also be eligible for discretionary bonuses. Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
    $79.1k-91.8k yearly Auto-Apply 14d ago
  • Associate, Wage and Hour - Disputes, Claims & Investigations

    Stout 4.2company rating

    Claim specialist job in Edison, NJ

    At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. Associate - DCI (Disputes, Claims & Investigations), Wage & Hour Stout is seeking an Associate with 2-5 years of experience to join our Disputes, Claims & Investigations (DCI) Wage and Hour practice. This is a full-time role offering comprehensive benefits, a 401(k), and eligibility for annual bonuses. Stout brings deep expertise supporting clients in high-stakes business litigation and economic consulting matters. Associates work closely with experienced professionals and subject-matter experts to analyze complex data and deliver independent, thoughtful analyses. Impact You'll Make This role plays a critical part in delivering high-quality analytical support on complex wage and hour matters. Your work will directly contribute to successful client outcomes and the effectiveness of project teams. Execute and support complex data analyses related to wage and hour disputes and investigations. Contribute to the development of sound methodologies and analytical approaches that support defensible conclusions. Help ensure projects are completed on time, within scope, and with a high standard of quality. Build strong working relationships across project teams to drive collaboration and efficiency. Support client-facing deliverables that clearly communicate findings and insights. What You'll Do These responsibilities reflect the day-to-day work required to support engagements and achieve project objectives. Review, organize, and analyze large and complex datasets to support litigation and consulting engagements. Support multiple concurrent projects, anticipating scope, timing, and budget considerations. Assist in developing work plans, methodologies, and resource needs to optimize project outcomes. Collaborate closely with team members to meet deadlines and manage competing client expectations. Support written analyses, reports, and presentations prepared for clients and other stakeholders. Apply creative problem-solving techniques to manage risks and address analytical challenges. What You Bring This section outlines the qualifications and technical skills needed to succeed in the role. Bachelor's degree from an accredited college or university, preferably in Economics, Mathematics, or a related field. 2-5 years of experience in wage and hour consulting or a closely related field. Working knowledge of advanced data management and analytical tools such as SAS, SQL, STATA, R, or similar platforms. Proficiency in Microsoft Office applications, including Word, Excel, PowerPoint, and Access. Strong written and verbal communication skills with the ability to present complex information clearly. Demonstrated ability to manage multiple projects simultaneously and work effectively with cross-functional teams. How You'll Thrive These competencies and behaviors will help you excel and grow within Stout's collaborative culture. Maintain flexibility and adaptability in response to changing project requirements and timelines. Demonstrate strong organizational skills and rigorous attention to detail. Exhibit intellectual curiosity, self-motivation, and a commitment to quality control. Collaborate effectively with colleagues while managing competing priorities. Uphold Stout's core values and deliver Relentless Excellence in both client service and internal teamwork. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success. en/careers/benefits The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $74,000.00 - $135,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.
    $32k-36k yearly est. 2d ago

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