Sr Claims Examiner (TPA Oversight)

The Jonus Group•Orange, CA

7h•Remote

About The Position

Seeking a highly skilled and experienced Senior Claims Examiner to join a growing TPA Oversight team. In this role, you will oversee Third-Party Administrator (TPA) adjusters handling a variety of casualty claims, including slip and falls, premises liability, bodily injury, New York Labor Law, and surety claims. This is an exciting opportunity to join a stable and growing organization with a unique business model and a supportive, flexible work environment.

Requirements

Minimum of 8 years of experience in Commercial General Liability claims handling.
Professional liability or employment liability experience is required.
Strong tenure in previous roles, demonstrating stability and commitment.
Experience handling claims involving bodily injury and litigation.
Must hold a Home State or Designated Home State adjuster license (company will assist with licensing in additional states as needed).
Prior experience with insurance carriers is required.
Proficiency in drafting coverage tenders, ROR letters, and other claim-related correspondence.
Strong skills in Microsoft Excel, with the ability to analyze and present data effectively.

Nice To Haves

Familiarity with New York Labor Law is a plus, but not required.
A combination of carrier and TPA experience is preferred.
Bachelor’s degree preferred, but not required.

Responsibilities

Oversee TPA adjusters managing a variety of casualty claims, ensuring compliance with company standards and best practices.
Review and approve coverage tenders, reservation of rights (ROR) letters, and other claim-related documentation.
Analyze data from TPAs and other departments, presenting findings to management in a clear and concise manner.
Collaborate with internal teams and external partners to ensure efficient and effective claims handling.
Provide guidance and support to TPA adjusters on complex claims, including those involving bodily injury and litigation.
Monitor and evaluate TPA performance, identifying areas for improvement and implementing corrective actions as needed.