Commercial Auto Liability, PIP/No Fault Team Leader

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🔥 0 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $89k - $99k / year

⏰ Full Time

🟠 Senior

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TRISTAR Insurance Group

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1987

🤝 B2B

⚕️ Healthcare Insurance

B2B • Healthcare Insurance

TRISTAR Insurance Group is a national third-party administrator (TPA) that provides insurance administration and risk management services to employers, insurers and public entities. Its solutions include property & casualty, workers' compensation, general and auto liability, managed care (bill review, case management, utilization review, nurse triage, pharmacy benefit management), absence and disability management, employee group benefits administration, and risk control and workplace safety services. TRISTAR emphasizes collaborative, technology-enabled and tailored services to transform risk into opportunity for its clients.

📋 Description

• Under the oversight of the Area Manager, the Claims Examiner III – Team Leader reports to the Claim Supervisor and/or Area Manager and is responsible for managing all aspects of Auto Liability and PIP/No-Fault claims from inception through resolution • Provides day-to-day guidance and technical support to Claims Examiners, ensuring consistency, quality, and adherence to best practices • Helps to establish procedures for American Arbitration Association to help reduce costs and improve process • Investigates and conducts investigations in a timely manner for claims assigned • Communicates with clients, claimants, providers, and vendors regarding claims issues • Computes and sets reserves within Company guidelines • Approves authority requests of direct reports for claims assigned and directs them to obtain authority as designated • Settles and/or finalizes all claims assigned and obtains authority as designated • Maintains diary system for case review and documents file to reflect the status and work being performed on the file assigned • Communicates appropriate information promptly to the Area Manager and client to resolve claims efficiently

🎯 Requirements

• Bachelor’s degree in related field (preferred) • Three (3) or more years related experience; or equivalent combination of education and experience • Technical knowledge of coverage, statutory regulations, and medical terminology • Strong Technical knowledge of NF/PIP Statutes in NY and NJ • Analytical skills • Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients, and staff • Ability to interact with persons at all levels in the business environment • Ability to independently and effectively manage very complex claims • Proficient in Word and Excel (preferred) • Active General Adjuster New York State License

🏖️ Benefits

• Medical, Dental and Vision insurance • Life & Disability Insurance • 401(k) Plan • Paid Holidays • Paid time off • Referral bonus