Claims Examiner - Liability

Job Description

Job DescriptionJob Title: Claims Examiner - LiabilityLocation: Marlton, NJHire Type: ContingentPay Range: $30.00/hourWork Type: Full-timeWork Model: RemoteWork Schedule: Monday – Friday, 9am – 5pm Recruiter Contact: Natalie Dunn, natalie@marykraft.comNature & Scope:Positional OverviewThe Imagine Group is recruiting for a Claims Examiner - Liability on behalf of our client, a leading global provider of technology-enabled risk, benefits, and integrated business solutions, delivering claims management, loss control, and employee benefits administration services across a wide range of industries in Marlton, NJ. Known for its client-focused approach and data-driven insights, the organization helps businesses navigate complex challenges while improving outcomes for employees and customers alike.In this role, you will be responsible for investigating, evaluating, and managing liability claims from initial intake through resolution, ensuring timely and accurate outcomes. You will analyze coverage, determine liability exposure, negotiate settlements, and maintain compliance with applicable laws, regulations, and best practices while delivering high-quality service to all stakeholders.Role & Responsibility:Tasks That Will Lead to Your Success

• Analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
• Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
• Assesses liability and resolves claims within evaluation.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level.
• Prepare necessary state filings within statutory limits.
• Manages the litigation process; ensures timely and cost-effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
• Manages claim recoveries, including but not limited to subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
• Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travel as required.

Skills & ExperienceQualifications That Will Help You Thrive

• Licenses that have GL and Auto BI experience
• Should hold licenses across all required states: NY, IN, TX, RI, FL, NC, SC, DE, AL.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Experience Five (5) years of claims management experience or equivalent combination of education and experience required.
• Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
• Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products.
• Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment.
• Ability to meet or exceed Service Expectations.
• When applicable and appropriate, consideration will be given to reasonable accommodation.
• Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
• Computer keyboarding.