Coverys
Overview
While professional experience and qualifications are key for this role, make sure to check you have the preferable soft skills before applying if required. Senior Claim Consultant - NJ
role at
Coverys . The Claims team is seeking a Senior Claim Consultant to join us in NJ, PA, MD, or Washington, DC. This is a remote position; qualified candidates must reside in one of these states to best serve our policyholders.
The base salary range is $100,000 - $136,000. Individual compensation packages are based on geographic location, skill set, experience, qualifications and education.
Responsibilities
Interview insureds, claimants, witnesses, and other appropriate parties to obtain information used to assess liability exposure.
Document file regarding results of investigation and negotiations.
Prepare reports to file on established diary dates and other specific reports as needed to ensure timely file documentation and plan of action.
Secure records for investigation and evaluation of cases.
Determine and implement negotiation strategy and negotiates settlements within authority level.
Adjust reserves within level of authority and make reserve recommendations to Manager/Director for amounts over position authority level.
Evaluate cases for appropriate disposition and seek authority for settlement from manager/director when settlement amount requests exceed authority.
Direct and monitor activities of defense counsel in compliance with Case Management Guidelines.
Monitor trials and attend pre-trial proceedings, mediations, and arbitrations as necessary.
Identify significant insured Risk Management or Underwriting issues and direct the information to appropriate department.
Communicate with insureds, claimants, and witnesses; consult medical and other relevant records, varying methods of investigation according to type of claim.
Analyze losses to determine if insurance coverage applies.
Maintain working knowledge of policy forms and can confirm policy in effect for date of loss.
Performs other duties as assigned.
Qualifications
Bachelor's degree from four-year college or university.
R.N. or J.D. preferred with 5 years’ experience in clinical nursing and/or 5 years claims experience dealing with serious bodily injury.
Insurance adjuster's license may be required for specific states.
Knowledge of medical, legal and insurance terminology is required.
Must hold a current driver's license.
Strong written and oral communication skills. Must be comfortable making oral presentations to staff and insureds.
Must have training in contract/policy review and application.
Ability to read, analyze, and interpret insurance policy coverage forms, professional journals, technical procedures, or government regulations. Ability to write reports, business correspondence, and technical case summaries. Ability to effectively present information and respond to questions from groups of managers, insured's, agents and attorneys.
Must be able to synthesize complex or diverse information; collect and research data; use intuition and experience to complement data; design workflows and procedures.
Must have the ability to design and generate creative solutions.
Experience with Microsoft Word, Excel, PowerPoint.
Able to work with minimal supervision on a day-to-day basis.
Ability to travel 20-25% required
Seniority level: Mid-Senior level
Employment type: Full-time
Job function: Finance and Sales
Industries: Insurance
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While professional experience and qualifications are key for this role, make sure to check you have the preferable soft skills before applying if required. Senior Claim Consultant - NJ
role at
Coverys . The Claims team is seeking a Senior Claim Consultant to join us in NJ, PA, MD, or Washington, DC. This is a remote position; qualified candidates must reside in one of these states to best serve our policyholders.
The base salary range is $100,000 - $136,000. Individual compensation packages are based on geographic location, skill set, experience, qualifications and education.
Responsibilities
Interview insureds, claimants, witnesses, and other appropriate parties to obtain information used to assess liability exposure.
Document file regarding results of investigation and negotiations.
Prepare reports to file on established diary dates and other specific reports as needed to ensure timely file documentation and plan of action.
Secure records for investigation and evaluation of cases.
Determine and implement negotiation strategy and negotiates settlements within authority level.
Adjust reserves within level of authority and make reserve recommendations to Manager/Director for amounts over position authority level.
Evaluate cases for appropriate disposition and seek authority for settlement from manager/director when settlement amount requests exceed authority.
Direct and monitor activities of defense counsel in compliance with Case Management Guidelines.
Monitor trials and attend pre-trial proceedings, mediations, and arbitrations as necessary.
Identify significant insured Risk Management or Underwriting issues and direct the information to appropriate department.
Communicate with insureds, claimants, and witnesses; consult medical and other relevant records, varying methods of investigation according to type of claim.
Analyze losses to determine if insurance coverage applies.
Maintain working knowledge of policy forms and can confirm policy in effect for date of loss.
Performs other duties as assigned.
Qualifications
Bachelor's degree from four-year college or university.
R.N. or J.D. preferred with 5 years’ experience in clinical nursing and/or 5 years claims experience dealing with serious bodily injury.
Insurance adjuster's license may be required for specific states.
Knowledge of medical, legal and insurance terminology is required.
Must hold a current driver's license.
Strong written and oral communication skills. Must be comfortable making oral presentations to staff and insureds.
Must have training in contract/policy review and application.
Ability to read, analyze, and interpret insurance policy coverage forms, professional journals, technical procedures, or government regulations. Ability to write reports, business correspondence, and technical case summaries. Ability to effectively present information and respond to questions from groups of managers, insured's, agents and attorneys.
Must be able to synthesize complex or diverse information; collect and research data; use intuition and experience to complement data; design workflows and procedures.
Must have the ability to design and generate creative solutions.
Experience with Microsoft Word, Excel, PowerPoint.
Able to work with minimal supervision on a day-to-day basis.
Ability to travel 20-25% required
Seniority level: Mid-Senior level
Employment type: Full-time
Job function: Finance and Sales
Industries: Insurance
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