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Senior Liability Claims Examiner

2 months ago


Philadelphia, Pennsylvania, United States Independence Blue Cross Full time

In the role as a Senior Claims Adjuster, you will handle claims for bodily injury and property damage claims. These claims include auto accidents, premises liability, police professional liability, and subrogation. A working knowledge of the New Jersey Tort Claim Act (Title 59) is preferred.

  • Promptly investigates all assigned claims for coverage, liability assessment, damages evaluation, and subrogation/contribution.
  • Ensures timely disposition of all claims in accordance with regulatory and statutory requirements.
  • Within granted authority, establishes appropriate loss and expense reserves with documented rationale.
  • Negotiates claims resolution within granted authority.
  • Establishes and executes appropriate action plans for claim resolution, including loss cost management.
  • Maintains a strong working knowledge of regulatory and jurisdictional requirements.
  • Demonstrates technical proficiency through timely, consistent execution of best claim practices and established claims handling guidelines.
  • Communicates effectively with internal and external customers on claims and account issues.
  • Maintains and manages a diary system and claim pending to efficiently and effectively resolve all claims.
  • Effectively manages litigation process and defense counsel to ensure timely and cost-effective outcomes.
  • Prepares and submits claim status and excess reports.
  • Performs special projects as assigned by the Supervisor/Manager.
Key Responsibilities:
  • Investigate and resolve complex claims in a timely and cost-effective manner.
  • Develop and implement effective action plans to resolve claims.
  • Communicate effectively with customers and stakeholders.
  • Manage and maintain accurate records and reports.
  • Collaborate with internal teams to ensure seamless claim resolution.
Requirements:
  • Bachelor's degree in a related field.
  • Minimum 5 years of experience as a Senior General Liability Adjuster.
  • Excellent interpersonal and communication skills.
  • Strong organizational and analytical skills.
  • Claims database systems knowledge is preferred.