Claims Representative, Casualty

4 weeks ago

Mount Laurel, United States Plymouth Rock Assurance Full time

The Casualty Claim Representative will be responsible for the handling of First and Third Party Bodily Injury claims in a Personal Lines/Commercial environment for the Plymouth Rock Operation.


Essential Functions and Responsibilities

  • Initiate prompt contact of all insureds/claimants/witnesses on all new claim assignments to conduct thorough coverage and liability/injury investigations. These investigations might require the representatives take in depth recorded statements to investigate coverage and liability/injury claims.
  • Analyze, review and interpret policies to assess coverage and liability. Provide advice to Excess and Primary coverage issues.
  • Conduct field investigations, interviews with insureds, witnesses and claimants while maintaining a pending of represented and unrepresented claimant cases.
  • Manage and direct outside vendors (Field/Counsel/Surveillance, etc.) to determine what investigation is necessary and give them direction to bring a claim to conclusion. Ensure only necessary work is completed.
  • Investigate cases timely so that reserves are established and maintained at proper levels. Revise reserves timely based on developments in the course of the claim.
  • Investigate the validity of bodily injury claims being presented by individual insureds/claimants or attorneys representing insureds/claimants. Be aware of certain “Red Flags” to identify potential fraudulent claims. Refer to SIU for investigation timely.
  • Handle complex claims to include coverage issues, UM/UIM, TNC, Commercial, Umbrella etc. Also, must have prior litigation handling.
  • Recognize and investigate subrogation potential.
  • Negotiate both 1st and 3rd party claims directly with injured parties and/or their attorneys.
  • Exercises proper judgment and decision making to analyze exposure, determine the proper course of action and make recommendations for final resolution.
  • Attend litigation proceedings to either represent the company or participate in arbitrations/depositions/settlement conferences/ mediations/ trials.
  • Attend all internal and external training events as required.
  • Participate in proactive team activities to achieve departmental and company objectives. May be asked to participate in special projects, committees or assignments from management.
  • Utilize all claims systems, Excel, Word and social media search engines.
  • Prepare case summary for significant reserve increase and/or trial alerts. Participate in roundtable discussions.
  • Effectively manage workload while maintaining diary and focus on claims quality.
  • Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations.
  • Adhere to departmental internal control requirements. Comply with Plymouth Rock’s standards, best practices and ethical guidelines, adhere to Plymouth Rock’s culture.


Qualifications and Education

  • A bachelor's degree (B.A.) from an accredited four year college or university.
  • 5 - 10 years’ experience handling liability commercial, homeowners, UM/UIM, Excess/Umbrella.
  • In-depth knowledge of litigation, arbitration and trial process, handle out of state claims, and/or Personal Injury Protection claims.
  • Currently holds and/or can readily obtain an out of State License(s) (i.e. - CT, Delaware, Florida, etc.). Professional designation such as IIA, AEI, Senior Claim Law Associate (SCLA) or Chartered Property Casualty Underwriting (CPCU) or be actively working towards a designation, preferred.
  • High level of self-motivation.
  • Have advanced skills in coverage, investigation, litigation/ legal issues, negotiations, evaluations, medical terminology, and subrogation.
  • Strong communication, organizational, customer service and time management skills.
  • Excellent problem solving skills.
  • Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations.


About the Company

The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner’s insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.

  • Claims Representative, Casualty

    2 days ago

    Mount Laurel, United States Plymouth Rock Assurance Full time

    The Casualty Claim Representative will be responsible for the handling of First and Third Party Bodily Injury claims in a Personal Lines/Commercial environment for the Plymouth Rock Operation.Essential Functions and ResponsibilitiesInitiate prompt contact of all insureds/claimants/witnesses on all new claim assignments to conduct thorough coverage and...

  • Claims Representative, Casualty

    2 days ago

    Mount Laurel, NJ, United States Plymouth Rock Assurance Full time

    The Casualty Claim Representative will be responsible for the handling of First and Third Party Bodily Injury claims in a Personal Lines/Commercial environment for the Plymouth Rock Operation. Essential Functions and Responsibilities Initiate prompt contact of all insureds/claimants/witnesses on all new claim assignments to conduct thorough coverage and...

  • Accounts Receivable Claims Representative

    4 weeks ago

    Mt Laurel, United States Virtua Health Full time

    Responsible for accurate and timely billing and account collections. Obtains required billing information / documentation (pre-certifications, codes, insurance information) and enters into database. Identifies and resolves denied claims, escalating a Claims Representative, Accounts Receivable, Claims, Representative, Billing, Customer Service, Healthcare

  • Experienced Catastrophe Claims Representative

    7 days ago

    Mount Vernon, United States Auto-Owners Insurance Full time

    Description Applications are accepted on an ongoing basis. An open position may not be available at this time. *There are multiple positions open across the 26 states in which we operate. The current locations for which we are seeking CAT Claim Reps are located in the job posting.* Auto-Owners Insurance, a top-rated insurance carrier, is...

  • Healthcare Data Specialist

    2 days ago

    Mount Laurel, New Jersey, United States ExamWorks Full time

    About Us:Exam Works is a leading provider of innovative healthcare services, including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management, and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators, and...

  • Customer Service Representative

    4 weeks ago

    Laurel, United States Debbie Murphy - State Farm Agent Full time

    Benefits: Health Plan Assistance Company parties Competitive salary Flexible schedule Opportunity for advancement Paid time off Training & development Wellness resources Bonus based on performance ROLE DESCRIPTION:As a Customer Service Representative - State Farm Agent Team Member with Debbie...

  • Customer Service Representative

    3 weeks ago

    Laurel, United States Debbie Murphy - State Farm Agent Full time

    Benefits: Health Plan Assistance Company parties Competitive salary Flexible schedule Opportunity for advancement Paid time off Training & development Wellness resources Bonus based on performance ROLE DESCRIPTION:As a Customer Service Representative - State Farm Agent Team Member with Debbie...

  • Insurance Customer Service Representative

    5 days ago

    Rocky Mount, United States Harrison Gray Search and Consulting LLC Full time

    Harrison Gray Search has partnered with an award-winning, independent insurance agency in North Carolina to help them find a Commercial Lines Account Manager. This is an excellent opportunity for someone interested in long-term growth and development. Position: Insurance Customer Service Representative Location: On-site As an Insurance Customer Service...

  • Account Representative

    4 days ago

    Laurel, United States Debbie Murphy - State Farm Agent Full time

    Benefits: Health Plan Assistance Growth Potential Hourly pay plus commission/bonus Paid time off (vacation and personal/sick days) Bonus based on performance Competitive salary Flexible schedule Opportunity for advancement Signing bonus Wellness resources Training & development Position...

  • Medical cpc coding specialist

    4 days ago

    Mount Laurel, United States ExamWorks Full time

    OverviewThe Medical CPC Coding Specialist position with Exam Works is a great opportunity for talented candidates who are enthusiastic about using their skills to make a difference in the world of health care!We are looking to bring to our team a CPC, CPC-A, or CPMA who will perform the impressive task of creating and writing reports based on medical records...

  • Insurance Customer Service Representative

    2 weeks ago

    Rocky Mount, NC, United States Harrison Gray Search and Consulting LLC Full time

    Harrison Gray Search has partnered with an award-winning, independent insurance agency in North Carolina to help them find a Commercial Lines Account Manager. This is an excellent opportunity for someone interested in long-term growth and development. Position : Insurance Customer Service Representative Location : On-site As an Insurance Customer...

  • Medical cpc coding specialist

    6 days ago

    Mount Laurel, United States ExamWorks Full time

    The Medical CPC Coding Specialist position with Exam Works  is a great opportunity for talented candidates who are enthusiastic about using their skills to make a difference in the world of health care!   We are looking to bring to our team a CPC, CPC-A, or CPMA who will perform the impressive task of creating and writing reports based on medical...

  • Patient Account Representative

    3 weeks ago

    Laurel, United States South Central Health System Full time

    The Healthcare Patient Account Representative is responsible for managing patient accounts, billing, and collections. This role involves interacting with patients to resolve billing inquiries, process payments, and ensure accurate and timely billing submissions. The ideal candidate will have strong analytical skills, attention to detail, and excellent...

  • Accounts Receivable Representative

    4 weeks ago

    Mt Laurel, United States National Worksite Staffing LLC Full time

    As an Accounts Receivable Representative, you will be responsible for a variety of revenue-related billing activities requiring data research and analysis, time management, self-motivation and teamwork. Proactive and clear written and verbal communication skills are essential. You will act as a billing system super-user. You will be expected to monitor your...

  • Revenue Cycle Specialist

    3 days ago

    Mount Laurel, New Jersey, United States National Worksite Staffing LLC Full time

    Job DescriptionWe are seeking a skilled Coding and Compliance Expert to join our team at National Worksite Staffing LLC. As an Accounts Receivable Representative - Medical Coder, you will play a vital role in ensuring the accuracy and efficiency of our revenue cycle process.In this position, you will be responsible for reviewing charge and claim edits,...

  • Customer Service Representative

    4 weeks ago

    Mount Laurel Township, United States Dane Cox - State Farm Agent Full time

    Benefits: Licensing paid by agency Bonus based on performance Competitive salary Flexible schedule Opportunity for advancement Paid time off Training & development ROLE DESCRIPTION:As a Customer Service Representative - State Farm Agent Team Member with Dane Cox - State Farm Agent, you will generate the...

  • Associate Attorney

    2 weeks ago

    Mount Laurel, United States Marshall Dennehey Full time

    Marshall Dennehey, a leading AM Law 200 civil defense law firm with more than 60 years of dedicated service to our corporate, insurance and individual clients, is seeking an Associate Attorney with one to four years of litigation experience to join our growing Workers’ Compensation Department in Mt. Laurel, New Jersey.This is an exceptional opportunity to...

  • Medical Claims Paralegal

    2 days ago

    Mount Pleasant, SC, United States Motley Rice Full time

    As one of the nation’s largest plaintiffs’ litigation firms, Motley Rice advocates for the rights of workers, families, consumers and investors and aggressively seeks justice for people and institutions harmed by wrongdoing and negligence. S. courts. We have the experience and depth of knowledge to take on innovative, cutting-edge litigation across a...

  • Agency Coordinator

    15 hours ago

    Mount Juliet, United States Combined, a Chubb Company Full time

    Job DescriptionJob DescriptionOverview:We are looking for the right individual to take a high performing sales role. Combined, a Chubb Company wasfounded in 1922, and we are a subsidiary of a well-known Fortune 500 company, one of the largest Insurance companies in the world that is 141 years old. We are relatively new to the market in West Tennessee...

  • Customer Experience Representative

    4 weeks ago

    Mount Juliet, United States KHS America, Inc. Full time

    KHS America is a musical instruments distributor managing more than 20 musical instrument brands.We are dedicated to the enrichment of lives through music performance and education by providing high qualitymusical instruments and services designed to support musicians, educators and our retail partners. The Customer Experience Representative resolves issues...