Claims Processor I

The Casualty Claim Representative will be responsible for the handling of First- and Third-Party Bodily Injury and Physical Damage claims in a Personal Lines /Commercial environment for the Plymouth Rock Operation. Read the overview of this opportunity to understand what skills, including and relevant soft skills and software package proficiencies, are required.
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. 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. 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. Have advanced skills in coverage, investigation, litigation/ legal issues, negotiations, evaluations, medical terminology, and subrogation. Handle more complex claims to include coverage issues, UM/UIM, etc.. Also, must have prior litigation handling.
Negotiate both 1st and 3rd party claims directly with injured parties or their attorneys.
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.
May be asked to participate in special projects, committees or assignments from management.
Possess strong organizational skills, able to demonstrate time management, has the ability to prioritize multiple tasks/duties, and be proficient in the utilization of all claims systems, Excel, Word and social media search engines.
Provide strong customer service. Capable of working independently without close supervision, high level of self motivation, effectively manage workload while maintaining diary and focus on claims quality.
Able to think strategically, solve problems, set priorities, make the necessary decisions to resolve complex/regular issues/claims.
Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations.
A bachelor's degree (B.A.) 3 - 5 years’ experience handling liability and/or Personal Injury Protection claims.
~1 year of experience handling bodily injury or casualty claims.
~ Some litigation experience and knowledge of the New Jersey court system is preferred.
~ Knowledge of PA, CT or NY claims handling would be beneficial.
~ Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.​ 4 weeks accrued paid time off + 9 paid national holidays per year
~ Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
~ Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
~ Robust health and wellness program and fitness reimbursements
~ Tuition Reimbursement


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.