Senior Casualty Claims Specialist – TPA Oversight
Everest Group•Warren, NJ
•Hybrid
About The Position
Everest Insurance, a member of Everest Re Group, Ltd., has an opportunity for an experienced claims professional or attorney to join our Auto and GL TPA Oversight - Casualty Claims team in Warren, NJ, New York, NY or Philadelphia, PA. This individual will handle TPA Oversight and quality assessment for general liability and commercial auto claims. This is a hybrid position working 3 days in office, 2 remote.
Requirements
- 6-8 years of claims handling experience or related legal experience
- Past supervision experience
- B.A. or B.S. required
- Strong analytical and organizational skills
- Excellent verbal and written communication skills
- Strong negotiation and investigation skills
- Strong computer use skills across multiple claim system platforms
- Ability to think strategically
- Ability to influence others and resolve complex, disputed claims
- In-depth knowledge of the litigation, arbitration, and trial process
- Currently holds or readily can obtain all required adjuster licenses
- Ability to identify and use relevant data and metrics to best manage claims
- Collaborative mind-set and willingness to work with people outside immediate reporting hierarchy to improve processes and generate optimal departmental efficiency
- Ability and willingness to present to senior management and to others in other group settings
- Ability to compose summary reports of quality review findings
- Ability to obtain vendor compliance to Everest claim department standards
- Knowledge of the insurance industry, claims process and legal and regulatory environment
Responsibilities
- Ensure compliance with Everest TPA Claim Handling Protocols
- Direct and report on focused claim reviews and file audits
- Maintain active diary system
- Actively manage and resolve claims when appropriate
- Participate in settlement conferences and mediation as needed
- Participate in meetings with policyholders and brokers as needed
- Analyze claims metrics including reserve accuracy, productivity, prompt communication; and expense management
- Develop and execute on action plans to address deficiencies identified within quality reviews
- Conduct regular meetings with TPA adjusters and managers to discuss trends and claim handling strategy
- Develop and maintain relationships with underwriting groups and brokers/agents.
- Work with business partners to address customer service issues
Benefits
- health insurance coverage
- an employee wellness program
- life and disability insurance
- 401k match
- retirement savings plan
- paid holidays
- paid time off (PTO)
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Senior
