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Core Specialty Insurance Holdings, Inc. · 1 day ago

Sr. Claims Examiner - PIP and Bodily Injury Claims Adjuster

Scottsdale, AZ

Full-time

Onsite

Senior Level

5+ years exp

Core Specialty Insurance Holdings, Inc. is seeking a Senior Claims Examiner primarily responsible for handling PIP claims and some Bodily Injury claims. The role involves evaluating claims, negotiating settlements, ensuring compliance with guidelines, and maintaining accurate records throughout the claims management process.

InsuranceMarine Transportation

No H1B

Responsibilities

Ensure compliance with established claim handling guidelines regarding coverage, investigation, liability, damages, evaluation, and resolution

Evaluating the nature and severity of PIP claims; reviewing medical bills, lost wages, and other expenses to determine if the insured is eligible for coverage based on policy terms, state regulations, and the specifics of each claim

Negotiating by developing a PIP settlement strategy and negotiating with the claimant, their employer, and/or legal counsel

Keeping track of your PIP log to ensure proper medical payments are made by the coverage available

Utilize critical thinking and solid judgment to solve problems, make decisions and resolve issues inherent in handling PIP and Bodily Injury losses, as well as plan and organize activities throughout the claim’s management process

Draft declination, Reservation of Rights and other coverage letters

Establish reserves pursuant to established reserving protocols and reserve authority procedures

Investigate commercial claims, while following corporate standards and guidelines

Investigate commercial claims and communicate with policyholders, and third-party claimants to reach fair and reasonable settlements

Review and negotiate material damage appraisals with mechanics, repair shops or similar vendors

In addition to the above key responsibilities, you may be required to undertake other duties from time to time as the Company may reasonably require

Qualification

PIP claims handlingBodily Injury claims handlingInsurance adjuster's licenseState lawsNegotiation skillsCritical thinkingComputer skillsTime managementDetail-orientedEffective communication

Required

Insurance adjuster's license required

College degree or equivalent work experience required

Minimum of 5 years' experience handling PIP claims required

Must be able to analyze Commercial Policy coverages, liability and damages

Possess a comprehensive understanding and knowledge of state and federal laws (including legislation) applicable to PIP and Auto Bodily Injury claims

Possesses an in-depth understanding of the policy language/coverage applicable to Commercial Auto Garage and General Liability claims

Ability to work independently, manage time and resources to accomplish multiple tasks in a fast paced, deadline-oriented environment

Computer skills – good working knowledge of MS Office, Excel and WORD

Must be detail-oriented to maintain accurate records of payment transactions, settlement offers, etc

Possess effective oral and written communication skills

Strong time-management skills, as some tasks will be time sensitive

Preferred

PIP litigation handling preferred

Experience handling Bodily Injury claims preferred

Ability to Travel occasionally

Ability to negotiate and be persuasive

Benefits

Medical, dental, vision, and life insurances

Short and long-term disability

A Company-match of 100% of a 6% contribution 401(k) plan

An Employee Assistance Plan

Health Savings Account

Flexible Spending Account

Health Reimbursement Account

A wellness program

Company

Core Specialty Insurance Holdings, Inc.

Core Specialty, through its subsidiary insurers, offers a diversified range of property, casualty, and marine insurance products for small to mid-sized businesses.

Founded in 2020

Jersey City, New Jersey, USA

1001-5000 employees