Cynet systems Inc
Claims Examiner - Liability - Remote / Telecommute
Cynet systems Inc, Marlton, New Jersey, us, 08053
Job Description
Pay Range: $17.42hr - $21.42hr
The Claims Examiner – Liability is responsible for analyzing, investigating, and resolving complex general liability claims.
This role manages claims through timely resolution, ensures compliance with applicable laws and regulations, and maintains strong communication with claimants, clients, vendors, and internal stakeholders.
Responsibilities
Analyze and process complex or technically difficult general liability claims by investigating and gathering information to determine claim exposure.
Manage claims through well-developed action plans to achieve appropriate and timely resolution.
Assess liability and negotiate settlements within designated authority levels.
Calculate, assign, and manage claim reserves throughout the life of the claim.
Calculate and pay benefits due; approve and issue timely claim payments and adjustments.
Prepare required state filings within statutory limits.
Manage the litigation process to ensure timely and cost-effective resolution.
Coordinate vendor referrals for investigations and litigation management.
Apply cost containment techniques, including strategic vendor partnerships, to reduce claim costs.
Manage claim recoveries including subrogation, excess recoveries, and Social Security and Medicare offsets.
Report claims to excess carriers and respond to requests in a professional and timely manner.
Communicate claim activity with claimants and clients while maintaining professional relationships.
Ensure claim files are properly documented and claims coding is accurate.
Refer cases to supervisors or management when appropriate.
Support organizational quality programs and perform other duties as assigned.
Requirement/Must Have
Minimum of five years of claims management experience or an equivalent combination of education and experience.
Strong knowledge of insurance principles and applicable laws for general liability claims.
Excellent negotiation skills with the ability to resolve claims within authority levels.
Strong analytical, interpretive, and problem‑solving skills.
Ability to manage multiple priorities and meet service expectations.
Experience
Experience managing complex liability claims, including litigation and vendor coordination.
Experience handling reserves, settlements, recoveries, and compliance-related filings.
Skills
Subject matter expertise in insurance principles, recoveries, offsets, and cost containment practices.
Excellent oral and written communication, including presentation skills.
Proficiency in Microsoft Office applications.
Strong organizational and interpersonal skills.
Ability to work effectively in a team environment.
Qualification and Education
Bachelor’s degree from an accredited college or university preferred.
Professional certification related to the line of business preferred.
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The Claims Examiner – Liability is responsible for analyzing, investigating, and resolving complex general liability claims.
This role manages claims through timely resolution, ensures compliance with applicable laws and regulations, and maintains strong communication with claimants, clients, vendors, and internal stakeholders.
Responsibilities
Analyze and process complex or technically difficult general liability claims by investigating and gathering information to determine claim exposure.
Manage claims through well-developed action plans to achieve appropriate and timely resolution.
Assess liability and negotiate settlements within designated authority levels.
Calculate, assign, and manage claim reserves throughout the life of the claim.
Calculate and pay benefits due; approve and issue timely claim payments and adjustments.
Prepare required state filings within statutory limits.
Manage the litigation process to ensure timely and cost-effective resolution.
Coordinate vendor referrals for investigations and litigation management.
Apply cost containment techniques, including strategic vendor partnerships, to reduce claim costs.
Manage claim recoveries including subrogation, excess recoveries, and Social Security and Medicare offsets.
Report claims to excess carriers and respond to requests in a professional and timely manner.
Communicate claim activity with claimants and clients while maintaining professional relationships.
Ensure claim files are properly documented and claims coding is accurate.
Refer cases to supervisors or management when appropriate.
Support organizational quality programs and perform other duties as assigned.
Requirement/Must Have
Minimum of five years of claims management experience or an equivalent combination of education and experience.
Strong knowledge of insurance principles and applicable laws for general liability claims.
Excellent negotiation skills with the ability to resolve claims within authority levels.
Strong analytical, interpretive, and problem‑solving skills.
Ability to manage multiple priorities and meet service expectations.
Experience
Experience managing complex liability claims, including litigation and vendor coordination.
Experience handling reserves, settlements, recoveries, and compliance-related filings.
Skills
Subject matter expertise in insurance principles, recoveries, offsets, and cost containment practices.
Excellent oral and written communication, including presentation skills.
Proficiency in Microsoft Office applications.
Strong organizational and interpersonal skills.
Ability to work effectively in a team environment.
Qualification and Education
Bachelor’s degree from an accredited college or university preferred.
Professional certification related to the line of business preferred.
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