Insurance Claims Examiner, Specialized Oversight

5 days ago


Iselin, New Jersey, United States LotSolutions, Inc. Full time

Job Overview

We are seeking an experienced Insurance Claims Examiner to provide specialized oversight in handling claims across various lines of business. This role requires technical expertise and strong analytical skills to identify potential large loss claims.

Key Responsibilities

  • Provide technical oversight of Third Party Administrators (TPAs) and ensure adequate reserving and accuracy of claims payments.
  • Analyze complex coverage issues and draft coverage letters to underwriting team and senior management.
  • Collaborate with the TPA Claims Manager to proactively manage claims and adhere to claim workflows and Service Level Agreements (SLAs).
  • Identify exposures and claim trends affecting the portfolio and provide written assessments to the Specialty business unit.
  • Effectively represent the Company's interests at mediations and settlement conferences.

Requirements

  • Bachelor's Degree or equivalent work experience.
  • 5+ years of claims handling or related experience.
  • Licensed Adjuster – Various States.
  • Juris Doctor degree preferred.

Benefits

  • Full benefit package including medical, dental, life, vision, company-paid short/long-term disability, 401(k), tuition assistance, and more.

Compensation

The estimated salary for this role is between $80,000 to $110,000 per year, depending on experience and qualifications.



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