Commercial Auto No Fault, PIP Claims Examiner III – Temp

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🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $85k - $95k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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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

• Responsible for the prompt review of policy information to determine coverage for loss/damage/injury. • Conduct an efficient claim examination and investigation leading to the final resolution of liability claims, including matters in litigation. • Frequent contact and interaction with involved parties including claimants and their legal representatives. • Recommendations regarding loss exposure and associated reserve and settlement strategy communicated to the client. • Review and interpret coverage, process, and conclude assigned Personal Injury Protection (PIP) claims including investigation and evaluation of Auto and/or General Liability Casualty Claims in the jurisdiction of NY and NJ. • Respond to PIP Arbitration Proceedings. • Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to advance the claim to conclusion. • Maintain an ongoing diary. • Continually assess exposure and evaluate accurate reserves and settlement recommendation. • Prepare Loss Reports providing thorough analysis of coverage, liability, and damages. • Determine if subrogation and/or risk transfer exists and initiate recovery efforts in the direction of the client. • Document all correspondence, reports, discussions, and decisions in the claim file record. • Provide outstanding service to the client.

🎯 Requirements

• High School Diploma or GED required; bachelor’s degree in related field (preferred) and three years auto and general liability casualty related experience; or equivalent combination of advanced education and experience. • At least three years of Automobile and General Liability claims experience required. • Knowledge of claims handling concepts, practices, and techniques, including but not limited to coverage issues, litigation management and product line knowledge. • Demonstrated verbal and written communications skills. • Demonstrated advanced analytical, decision-making and negotiation skills. • Computer proficiency. • Ability to communicate effectively and clearly, both orally and in writing. • Ability to manage relationships in a fast-paced environment, while demonstrating problem solving and decision-making skills to work with customers. • Good analytical abilities to review, exercise judgment and evaluate claims to make sound decisions with a minimal amount of supervision. • Excellent customer service skills. • An understanding of the litigation process and case valuation in multiple jurisdictions. • Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently and exhibit good common sense. • An ability to handle assigned claims following company guidelines and industry best practices with a minimal amount of supervision. • Time management skills, organizational skills, and ability to prioritize issues and tasks. • Ability to effectively operate computer equipment and applications. • Independence, flexibility, and creativity. • Candidate must have a New York State Adjuster License.

🏖️ Benefits

• None specified