Senior Claims Representative, Casualty

plymouthrock; Mount Laurel Township (NJ); On-site; USD 81,000 - 105,000; Full time

Benefits offered by this job

4 weeks accrual PTO + 9 holidays

Health insurance from day 1

401(k) employer contribution

Professional development resources

Tuition reimbursement

Job summary

The Plymouth Rock Company in New Jersey is seeking a Senior Casualty Claim Representative to handle First- and Third-Party Bodily Injury and Physical Damage claims in a Personal Lines/Commercial environment. This role requires investigations, coverage analysis, and working with outside vendors to bring claims to resolution.

The ideal candidate has 4+ years of bodily injury or casualty claims experience, plus litigation exposure and NJ knowledge.

Qualifications

• Bachelor's degree from an accredited four-year college.
• 3–5 years’ liability/personal injury protection claims experience.
• 4+ years handling bodily injury or casualty claims.
• Litigation exposure and NJ court system knowledge preferred.
• Out-of-state licenses (e.g., CT, DE, FL) preferred.

Responsibilities

• Initiate contact with insureds/claimants to investigate coverage and liability.
• Analyze policies to assess coverage and liability; advise on excess/primary issues.
• Interview insureds, witnesses and claimants; manage representation diary.
• Direct outside vendors to conduct necessary investigations and control costs.
• Establish and adjust reserves; monitor developments impacting exposure.
• Investigate potential fraud; involve SIU when appropriate.
• Handle complex claims including coverage, UM/UIM, subrogation; prior litigation experience.
• Negotiate 1st and 3rd party claims with injured parties or attorneys.
• Attend litigation proceedings as necessary; participate in trainings and team activities.
• Maintain strong organizational skills; utilize claims systems, Excel and Word.

Skills

Bodily injury handling

Investigation

Negotiation

Litigation knowledge

Subrogation

Communication

Time management

Claim systems

Excel

Word

Education

Bachelor's degree

Tools

Claims systems

Excel

Word

Job description

The Senior Casualty Claim Representative will be responsible for the handling of First- and Third-Party Bodily Injury and Physical Damage claims in a Personal Lines /Commercial environment for the Plymouth Rock Operation. The candidate must have the skills listed below and be able to perform the following duties

RESPONSIBILITIES

• Initiate prompt contact of all insureds/claimants/witnesses on all new claim assignments to conduct thorough coverage and liability/injury investigations. These investigations might require the representatives take in depth recorded statements to investigate coverage and liability/injury claims.
• Analyze, review and interpret policies to assess coverage and liability. Provide advice to Excess and Primary coverage issues.
• Willing to conduct investigations, interviews with insureds, witnesses and claimants while maintaining a pending of represented claimant cases.
• Manage and direct outside vendors (Field/Counsel/Surveillance, Etc..) to determine what investigation is necessary and give them direction to bring a claim to conclusion. Ensure only necessary work is completed.
• Investigate cases timely so that reserves are established and maintained at proper levels. Revise reserves timely based on developments in the course of the claim.
• Investigate the validity of bodily injury claims being presented by individual insureds/claimants or attorneys representing insureds/claimants. Be aware of certain “Red Flags” to identify potential fraudulent claims. Refer to SIU for investigation timely.
• Have advanced skills in coverage, investigation, litigation/ legal issues, negotiations, evaluations, medical terminology, and subrogation. Handle more complex claims to include coverage issues, UM/UIM, etc.. Also, must have prior litigation handling.
• Recognize and investigate subrogation potential.
• Negotiate both 1st and 3rd party claims directly with injured parties or their attorneys.
• Exercises proper judgment and decision making to analyze exposure, determine the proper course of action and make recommendations for final resolution.
• Attend litigation proceedings to either represent the company or participate in arbitrations/depositions/settlement conferences/ mediations/ trials.
• Attend all internal and external training events as required.
• Participate in proactive team activities to achieve departmental and company objectives. May be asked to participate in special projects, committees or assignments from management.
• Possess strong organizational skills, able to demonstrate time management, has the ability to prioritize multiple tasks/duties, and be proficient in the utilization of all claims systems, Excel, Word and social media search engines.
• Have strong communication skills both verbal and written. Provide strong customer service. Prepare case summary for significant reserve increase and/or trial alerts. Participate in roundtables.
• Capable of working independently without close supervision, high level of self motivation, effectively manage workload while maintaining diary and focus on claims quality.
• Ability to handle multiple responsibilities and be adept at conflict resolution while working in a team environment. Work well under pressure. Able to think strategically, solve problems, set priorities, make the necessary decisions to resolve complex/regular issues/claims.
• Possess knowledge of and adherence to State(s) laws and regulatory claim handling guidelines and statutory regulations.
• Adhere to departmental internal control requirements. Comply with Plymouth Rock’s standards, best practices and ethical guidelines, adhere to Plymouth Rock’s culture

QUALIFICATIONS

• A bachelor's degree (B.A.) from an accredited four year college or university.
• 3 - 5 years’ experience handling liability and/or Personal Injury Protection claims.
• 4+ years of experience handling bodily injury or casualty claims.
• Some litigation experience and knowledge of the New Jersey court system is preferred.
• Knowledge of PA, CT or NY claims handling would be beneficial.
• Currently holds and/or can readily obtain an out of State License(s) (i.e. - CT, Delaware, Florida, etc.) is preferred

The pay range for this position is $81,000 to $105,000 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.

PERKS & BENEFITS

• 4 weeks accrued paid time off + 9 paid national holidays per year
• Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
• Annual 401(k) Employer Contribution
• Free onsite gym at our Woodbridge Location
• Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
• Robust health and wellness program and fitness reimbursements
• Various Paid Family leave options including Paid Parental Leave
• Tuition Reimbursement

ABOUT THE COMPANY

The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner’s insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.