Claims Examiner

Berkley • Moorestown Township, NJ

1d • Hybrid

About The Position

The Claims Examiner determines and discharges the company’s contractual obligations under its insurance policy contracts. The role involves coverage analysis, investigation, legal defense, and loss and expense reserving. The examiner incorporates claims into company records, reviews them for coverage applicability, establishes and maintains reserves, and works with managers and the Claims Committee on coverage questions, reserves, settlement authority, and large loss reports.

The position provides ongoing direction to adjusters, investigators, and defense attorneys to ensure claims are handled adequately. It may involve attending mediations and trials with supervision, reviewing billing statements, and keeping current on applicable procedures, case law, statutory requirements, and industry practices. The role may require up to 20% travel.

Requirements

• Minimum of three years of progressive commercial insurance claims handling experience.
• Ability to assess priorities and manage deadlines effectively.
• Effective verbal and written communication skills.
• Strong research and analytical skills.
• Strong problem-solving and organizational skills.
• Customer-service orientation.
• Proficiency with the MS Office Suite.

Nice To Haves

• Bachelor’s degree or equivalent work experience.

Responsibilities

• Incorporate claims into company records and review them for applicability of coverage.
• Discuss coverage questions, reserves, and settlement authority with the Manager and Claims Committee according to best practices, including preparing large loss reports.
• Present claim facts and recommendations to the committee as necessary.
• Establish initial loss and expense reserves and maintain valid reserves based on current investigation and legal discovery.
• Provide ongoing direction to adjusters, investigators, and defense attorneys to ensure claims are adequately handled.
• Attend and participate in mediations and trials as necessary, with supervision.
• Follow company procedures and guidelines, case law, and statutory requirements when coverage is in question or when paying or denying claims.
• Review trade journals, Unfair Claim Practice Acts, and other materials to maintain current knowledge related to the role.
• Review incoming billing statements for accuracy and process them for payment.
• Attend industry-related seminars, workshops, and courses for continuing education.
• Perform additional tasks as assigned.

Benefits

• Competitive compensation plan and robust benefits package for full-time regular employees.
• Eligible to participate in the annual discretionary bonus program.
• Health, dental, vision, life, and disability benefits.
• Wellness benefits.
• Paid time off.
• 401(k) plan.
• Profit-sharing plan.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed