Claims Examiner - Hybrid

Under general supervision, provide guidance and oversight in the investigation and disposition of auto and casualty claims which exceed the authority of the Claim Offices. Drive knowledge transfer and talent development while developing “mentor” level relationships. Leverage your superior technical expertise in auto and casualty liability to consistently deliver quality outcomes and exceptional customer experience. Maintain responsibility and oversight for PIP Litigation including assignment, authority, and analytics.

Key Responsibilities:

• Reviews auto, casualty, and PIP claims that are above specified amount or involve serious coverage questions.      
• Negotiates and makes decisions on PIP Litigation assignment, settlement values, and proper disposition.      
• Reviews and analyzes court decisions and legislation which may impact on claim handling and advises field on all important developments and trends.       
• Participates in the investigation, negotiation and settlement of selected claims.       
• Provides technical information and assistance to claim personnel on claims not filed or reviewed in the Home Office when requested and visits Claim Offices on occasion to discuss technical or communication problems.       
• Develops and maintains claim handling procedures for claim offices in a specific line of insurance and analyzes field reviews to assure that company policy and procedures are being implemented in the field.       
• Counsels with Home Office and Claim Office personnel on problems that were identified by the field reviews.      
• Participates in departmental preparation, dissemination and implementation of technical materials, source materials and other work tools.      
• Keeps abreast of current trends and innovations which affect claim handling to assure that our claim service is competitive.       
• Some direct handling of large losses, travel, and field work may be required.       
• Establish strong, collaborative and supportive relationships with Branch Claim Offices; including periodic visits to assigned offices.
• Drive knowledge transfer and talent development while developing “mentor” level relationships.       
• Dynamic participation in Large Loss Roundtables.       
• Assist in the identification and selection of experts; includes assistance in defining specific question(s) expert should be addressing.       
• Deliver superior litigation, loss cost and ALAE management results on assigned losses as well as providing technical support to Branch Claim Offices in their achievement of the same objectives.
• Key technical liaison between Home Office Claim and BCOs for PIP Litigation.
• Proactively monitor changes in law, regulatory requirements and loss trends and actively engage in the development of requisite solutions to minimize impact to claim outcomes and customer experience.       
• Support and drive strong fraud focus and partnership with SIU.      
• Encourage and actively support effective engagement and utilization of all available resources.      
• Drive strong, yet appropriate trial appetite.       
• Provide regular, constructive feedback to Claim Professionals, TMs and Managers.
• Involvement in the development and delivery of technical training      
• Identify and recommend talent development opportunities at Claim Professional, TM, and Manager levels.       
• Performs other related work as required or requested.

Requirements

• Extensive claim work experience in PIP and BI with expert knowledge and ability to provide guidance and direction to Claim employees.
• Make effective judgements on the most complex claims.
• Excellent ability to train and mentor employees and develop training materials.
• Strong relationship building, communication and collaboration skills.

Our current reasonable and good faith estimate of the annual salary or hourly wage range for this position is approximately $90,000 - $110,000 based on a variety of factors including, but not limited to, relevant skills and experience, educational background and certifications, performance and qualifications, market demand for the role and other organizational needs.

Please note: The advertised pay range is not a guarantee or promise of a specific wage.