Senior Claims Representative, Bodily Injury: Independent Agent Channel

4 weeks ago


Parsippany, New Jersey, United States Plymouth Rock Assurance Full time
Job Summary:

The Senior Claims Representative will be responsible for handling First and Third Party Bodily Injury claims in a Personal Lines/Commercial environment for the Plymouth Rock Operation. This role requires a high level of self-motivation, advanced skills in coverage, investigation, litigation/ legal issues, negotiations, evaluations, medical terminology, and subrogation. The ideal candidate will have a bachelor's degree and 10 years of experience handling liability commercial, homeowners, UM/UIM, Excess/Umbrella claims.

Key Responsibilities:

Initiate prompt contact of all insureds/claimants/witnesses on all new claim assignments to conduct thorough coverage and liability/injury investigations.
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 Rocks standards, best practices and ethical guidelines, adhere to Plymouth Rocks culture.

Requirements:

Bachelor's degree (B.A.) from an accredited four year college or university.
10 years experience handling liability commercial, homeowners, UM/UIM, Excess/Umbrella claims.
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 homeowners 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.

  • Parsippany, New Jersey, United States Plymouth Rock Assurance Full time

    Job Title: Senior Claims Representative, Bodily InjuryAt Plymouth Rock Assurance, we are seeking a highly skilled and experienced Senior Claims Representative to join our team. As a key member of our claims department, you will be responsible for handling complex bodily injury claims in a commercial environment.Key Responsibilities:Investigate and analyze...


  • Parsippany, New Jersey, United States NJM Insurance Group Full time

    Job Title: PIP Claims RepresentativeNJM Insurance Group is seeking a highly skilled PIP Claims Representative to join our team. As a PIP Claims Representative, you will be responsible for conducting thorough investigations on assigned claims and managing those claims through their life cycle.Key Responsibilities:Conduct complete and thorough investigations...


  • Parsippany, New Jersey, United States Jobot Full time

    Job Title: Senior Claims ExaminerAbout the Role:We are seeking a dedicated and experienced Senior Claims Examiner to join our dynamic team at Jobot. This is an excellent opportunity for individuals who are passionate about the finance industry and are looking to take their career to the next level.Key Responsibilities:1. Manage a portfolio of complex and...


  • Parsippany, New Jersey, United States NJM Insurance Group Full time

    The NJM Insurance Group is seeking a skilled Claims Account Specialist to join our team in Parsippany, NJ. This full-time position offers a hybrid schedule after training and provides an opportunity to work with various stakeholders, including policyholders, injured workers, medical providers, and vendors.The ideal candidate will have experience in workers'...


  • Parsippany, New Jersey, United States NJM Insurance Group Full time

    NJM Insurance Group is seeking a skilled Claims Account Specialist to join our team. This is a full-time position that offers a hybrid schedule after training.The Claims Account Specialist will be responsible for contacting all parties involved in the claim, gathering, and securing all necessary information to effectively evaluate the claim and implement an...


  • Parsippany, New Jersey, United States Plymouth Rock Assurance Full time

    Total Loss Claims Representative RoleThe Total Loss Claims Representative plays a crucial role in the Claims Organization, responsible for identifying, negotiating, and settling total losses with insureds and claimants. This position requires strong communication and organizational skills to effectively manage multiple tasks and prioritize claims.Key...


  • Parsippany, New Jersey, United States Plymouth Rock Assurance Full time

    **Job Title:** Total Loss Claims Representative**About the Role:**We are seeking a skilled Total Loss Claims Representative to join our team at Plymouth Rock Assurance. As a Total Loss Claims Representative, you will be responsible for negotiating and settling total loss and diminished value claims with vehicle owners.**Responsibilities:**Negotiate and...


  • Parsippany, New Jersey, United States Plymouth Rock Assurance Full time

    About the RoleThe Total Loss Claims Representative plays a critical role in our Claims Organization, responsible for identifying, negotiating, and settling total losses with insureds and claimants. This position requires strong communication and organizational skills, as well as the ability to work independently and as part of a team.Key...


  • Parsippany, New Jersey, United States NJM Insurance Group Full time

    Job Summary:NJM's Workers' Compensation Claims Team is seeking a Claims Account Specialist to join our team. This is a full-time position that offers a hybrid schedule after training.Key Responsibilities:Contact all parties involved in the claim, gathering and securing necessary information to effectively evaluate the claim and implement an action plan to...

  • Claims Director

    4 weeks ago


    Parsippany, New Jersey, United States Plymouth Rock Assurance Full time

    Subrogation Director Job DescriptionPlymouth Rock Assurance is seeking a highly skilled Subrogation Director to join our team in Boston, MA or Parsippany, NJ. As a key member of our executive team, you will be responsible for leading our Subrogation Teams and driving innovation in claims management.Key Responsibilities:Define and Execute Long-term Strategy:...


  • Parsippany, New Jersey, United States The Bianchi Law Group LLC Full time

    About UsThe Bianchi Law Group LLC is a dedicated team of trial attorneys led by former prosecutors. Our team is driven by courage, compassion, and commitment. We stand up for our clients in court and against adversaries, recognizing that we are often their last line of defense or hope during distress and crisis.Our TeamOur team consists of former prosecutors...


  • Parsippany, New Jersey, United States The Bianchi Law Group LLC Full time

    Job Title: Personal Injury Attorney (Part-time)Location: The Bianchi Law Group, LLCAbout Us:We are a dedicated team of trial attorneys led by former prosecutors and driven by courage, compassion, and commitment. Our team consists of former prosecutors who are skilled trial attorneys. They bring deep experience from government criminal prosecution, where...


  • Parsippany, New Jersey, United States The Bianchi Law Group LLC Full time

    About Us:The Bianchi Law Group LLC is a dedicated team of trial attorneys led by former prosecutors. Our team is driven by courage, compassion, and commitment. We stand up for our clients in court and against adversaries, recognizing that we are often their last line of defense or hope during distress and crisis. We express empathy and treat our clients...


  • Parsippany, New Jersey, United States Plymouth Rock Assurance Full time

    Total Loss Claims AdjusterOverview:The Total Loss Claims Adjuster plays a critical role in the claims process, responsible for identifying, negotiating, and settling total losses with insureds and claimants. This position requires strong communication and problem-solving skills, as well as the ability to work independently and as part of a...


  • Parsippany, New Jersey, United States MAX Surgical Specialty Management Full time

    Insurance Claims Specialist Job DescriptionWe are seeking a highly skilled Insurance Claims Specialist to join our team at MAX Surgical Specialty Management. As an Insurance Claims Specialist, you will play a crucial role in ensuring the accuracy and efficiency of our insurance claims process.Key Responsibilities:Claim Preparation and Submission: Prepare and...


  • Parsippany, New Jersey, United States Aston Carter Full time

    Job Title:Medicaid Claims AnalystJob Description:The Medicaid Claims Analyst is responsible for the Medicaid Drug Rebate process, which includes validating, verifying, disputing when necessary, and remitting payment for assigned state Medicaid agencies, SPAPs, and Supplemental Rebates. The Analyst is accountable for submitting payments within deadlines and...

  • Senior Underwriter

    4 weeks ago


    Parsippany, New Jersey, United States AIG Full time

    Job SummaryWe are seeking an experienced Senior Underwriter to join our team at Western World Insurance, a leading provider of commercial insurance solutions. As a key member of our Northeast Region team, you will be responsible for underwriting, maintaining, and growing a book of business, developing and maintaining client and broker relationships, and...

  • Senior Underwriter

    4 weeks ago


    Parsippany, New Jersey, United States AIG Full time

    About Western WorldWestern World has been a leading provider of non-admitted insurance solutions for over five decades. Our expertise in contract bind property, casualty, and garage segments, combined with the capabilities of Lexington Insurance, enables us to offer comprehensive non-admitted solutions to commercial brokers. Headquartered in Parsippany, New...


  • Parsippany, New Jersey, United States Plymouth Rock Assurance Full time

    Job SummaryThe SIU Supervisor will oversee the operation of a unit of SIU Investigators with varying levels of experience who handle investigations on suspect claim and underwriting matters. This role requires a strong leader who can direct and control the work of remote SIU Investigators, establish and monitor unit goals for service, production, and work...


  • Parsippany, New Jersey, United States NJM Insurance Group Full time

    About the RoleWe are seeking a highly skilled and organized Senior Legal Administrative Assistant to join our Workers' Compensation Legal department at NJM Insurance Group. This is a unique opportunity to work in a dynamic and collaborative environment, supporting our attorneys in the day-to-day management of litigated files.Key ResponsibilitiesPrepare and...