A Claims Examiner evaluates insurance claims in accordance with applicable contracts and government regulations within their insurance type. Determines member eligibility and financial responsibility of the insurance company.
Edison, NJ Job Details Full-time $61,700 - $141,400 a year 3 hours ago Qualifications Writing skills Bachelor's degree Liability insurance knowledge
Full Job Description Position Summary :
The examiner adjusts and defends claims and lawsuits against our insureds. It entails reviewing policies to determine coverage, resolving questions of coverage, investigating and making liability determinations, and evaluating damages such as property damage or medical records.
Essential Duties and Responsibilities:
Review and verify coverage for each claim, includes policy review and comparing to allegations made by the claimant. Issue timely coverage position letters. Conduct factual investigation directly or with the assistance of investigators. Review and analyze various documents such as contracts, leases, condo/co-op governing documents, the insured's business records, public records, medical records, property damage scopes, etc. Setting proper reserves timely; making a fair and prompt settlement determination. Negotiate settlements. Follow all company and departmental protocols. Direct defense counsel, monitor/review discovery. Maintain accurate and complete file notes. Maintain current and meaningful diary system. Participates in special projects and performs additional duties as required.
Education and Experience:
Bachelors Degree required. CPCU, AIC, SCLA and other insurance professional designations preferred. 2+ years of experience handing premises liability claims required. Familiarity with ImageRight, WINS, EXCEL and Microsoft Office a plus.
Skills:
Strong written and verbal communication skills required as well as good interpersonal, analytical and negotiation skills. Intellectual curiosity. A strong sense of urgency. Ability to establish relationships and rapport with insured's brokers, attorneys, etc. Ability to empathize with unrepresented claimants.
Other Requirements:
Ability to travel occasionally, generally locally. Attain/maintain any licenses in states that require them if assigned to those states. The salary range for this role is $61,700-$141,400. The listed annual salary range posted for this position is subject to change and may vary depending on performance, education, experience, skills, geographic location, travel requirements, demonstrated proficiency in the competencies required for the role and business needs. Base pay is just one component of GNY's total compensation package for employees. Other rewards include eligibility for an annual discretionary bonus based on performance.
