Claims Examiner II

Athens Administrators - Parsippany, NJ (12 days ago)3.5


Athens Administrators
Job Description

Job Title: Claims Examiner II – Property & Casualty
Department: Liability Claims, Parsippany, NJ or Orlando, FL
Reports To: Claims Supervisor
FLSA Status: Exempt
Job Class: 11

COMPANY DETAILS
Since our founding in 1976, Athens Administrators has been a recognized leader in third party claims administration services. But more important than what we do is how we do it. We provide service that translates into real and lasting benefits—every single day. With four offices in California and one in New Jersey and Florida, Athens Administrators offers Workers’ Compensation, Property & Casualty, Managed Care and Program Business solutions. Athens is proud to be a family-run company offering a nurturing and caring environment to employees at all levels.
JOB SUMMARY
Athens Administrators has an immediate need for a full-time Claims Examiner II to support our Parsippany, NJ office located on Wood Hollow Road. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. As an Inside Property and Casualty Claims Examiner II, this candidate will be responsible for the review, analysis and process of Auto Dealer Commercial Auto claims. These claims are typically low to moderate exposure and often entail an understanding of both direct and primary auto dealer coverages. The goal of the position is to ensure the delivery of quality service to customers while protecting their interests.

PRINCIPAL DUTIES AND RESPONSIBILITIES
Incumbent must have the skills, ability and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation:

Advanced knowledge in the following areas: 1) claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge, especially in the area of auto dealer and garage keeper exposures, 2) functional knowledge of law and insurance regulations in multi-state jurisdictions, 3) demonstrated advanced verbal and written communications skills, 4) demonstrated advanced analytical, decision making and negotiation skills.

Investigate, evaluate and determine settlement value or denial of liability for low to moderate level claims.
Within prescribed settlement authority for line of business, establish appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Make recommendations to set reserves at appropriate level for claims outside of authority level.
Prepare comprehensive reports as required. Identify and communicate specific claim trends and account and/or policy issues to management.
When necessary, manage the litigation process through the retention of counsel. Adhere to the line of business litigation guidelines to include budget, bill review and payment.
Document and manage claims (i.e.: record statements, update diaries, write reports) from inception to closure.
Ensure appropriateness of all payments.
Negotiate settlement of claims within individual authority level.
Create, maintain and update action plans for each assigned claim.
Coordinate and work with a vendor services such as appraiser, independent adjusting firms, contractors, emergency repair, cleaning services and various replacement services.
Capability to adjust Garage Keeper commercial automobile physical damage and property damage claims.
Facilitate between claimants, clients, brokers and attorneys in resolution of liability claims.
Exchange information with clients, claimants, insurance brokers, inspectors, producers and account managers.
Provide customer service and support to insureds and claimants.
Attend meetings and educational seminars for professional development.
Maintain required licenses.
Conduct quarterly claim reviews with the client.

ESSENTIAL JOB REQUIREMENTS
The requirements listed below are representative of the knowledge, skill, and/or ability required.

High school diploma required, college degree preferred
State adjusters license(s) required within one year; NY adjusting license within 90-days of hire
Relies on extensive experience and judgment to plan and accomplish goals with a minimum 5-7 years commercial auto experience
Garage Keepers and General Liability experience required
Knowledge of tort law, civil procedure and contract law
Knowledge of property and casualty insurance policies
Well-developed verbal and written communication skills
Ability to follow directions
Strong attention to detail and the ability to research and resolve problems
Excellent organizational skills
Ability to manage multiple tasks simultaneously
Ability to work independently and in a group setting
Ability to operate standard office equipment (fax, phone, printer, scanner, etc.)
Ability to work in a paperless environment
Ability to type quickly, accurately and for prolonged periods
Must demonstrate accuracy and thoroughness in work product
Ability to sit for prolonged periods of time
Infrequent lifting of up to 20lbs may be required
Computer literate and experience navigating various computer systems, including MS Word, Excel and Outlook and database management.
Ability to learn additional computer programs
Negotiation skills