NJM Insurance Group · 19 hours ago
Claims Account Specialist, I
Parsippany, NJ
Full-time
Hybrid
New Grad, Entry Level
$51K/yr - $59K/yr
0+ years expNJM Insurance Group is seeking a Claims Account Specialist, I who will be responsible for evaluating claims and implementing action plans. The role involves communicating with various stakeholders, ensuring quality management of claims, and providing excellent customer service to promote return to work outcomes.
InsuranceManufacturingTransportation
Responsibilities
Execute on strategic and operational goals and objectives of the WCC department and company business goals, guidelines, and programs
Recommend process improvements where applicable to improve department efficiency, work product, and service commitment to interested parties
Ensure quality management of claims in accordance with claims best practices and company guidelines, proactive action plans to drive positive return to work results while presenting timely, accurate documentation of claim activity
Investigate and analyze the loss event, injury, and relevant information to make a compensability determination and recommend a course of action
Administer the delivery of timely, appropriate, and accurate indemnity and medical benefits
Provide a high level of customer service that promotes injured worker advocacy-based principles to maximize return to work motivation and improve outcomes for all parties
Recognize and investigate subrogation opportunity for recovery of third-party funds
Work with the policyholder and NJM Loss Control to assist and develop stay at work / return to work efforts
Investigate potential fraud indicators in collaboration with the SIU team
Initiate and provide excellent communication with all stakeholders (injured workers, providers, attorneys, brokers, clients, etc.) professionally and proactively with a customer-centric approach
Consistently question and probe all aspects of assigned claims to achieve full understanding of facts
Comply with, and conduct all activities within state WC claims laws and fair practices, NJM’s Code of Ethics, and NJM’s Best Practices and Policies
Build rapport with the policyholder, educate the policyholder on NJM procedures, policies, and claim practices, and evaluate the policyholder’s reporting practices
Include accountability in managing service expectations and rapport and trust with assigned large accounts
Prepare, attend, and participate in Claim Reviews as needed with the Claims Supervisor
Participate in training programs to keep current on relevant issues/topics
Demonstrate a commitment to NJM’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards, and laws applicable to job responsibilities in the performance of work
Qualification
Required
Level I - 0-3 years' experience as a Workers' Comp Claim Representative, or comparable knowledge and experience with various aspects of claims handling and/or process including basic knowledge of WC Law, medical terminology, and utilization of an automatic claims processing system
Ability to manage return to work expectations with employers, doctors, and injured workers
Strong written and oral communication skills with ability to work both in a team setting and independently
Sound decision-making and critical thinking capabilities
Demonstrated organizational and communication skills
Superior customer service skills and ability to engage in business interactions with a polite, courteous, and professional manner
Working knowledge of Microsoft Office suite of tools (Word, Excel)
Ability to travel for business purposes, approximately less than 10%
Preferred
Multi-state experience and/or licensing (including NJ, MD, CT, DE, PA and/or NY)
Associate or bachelor's degree
AIC/CPCU Designations
Benefits
401(k) with employer match up to 8% and additional service-based contributions
Health, Dental, and Vision insurance
Life and Disability coverage
Generous PTO
Paid Sick Leave
Paid parental leave in addition to state-mandated leave
Discretionary bonuses
Company
NJM Insurance Group
NJM (New Jersey Manufacturers) is an auto, homeowners, renters, commercial auto, umbrella and workers' compensation insurance providers.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Chris Malone
SVP, CFO & Treasurer
Carol Voorhees
Senior Vice President & Chief Information Officer
Recent News
2026-01-16
Company data provided by crunchbase