Senior Claims Examiner - Healthcare

Full Time
Jersey City, NJ 07311
Posted
Job description
The Position:

Arch Insurance Group Inc., AIGI, has an opening with the Claims Division on the Healthcare Team as a Senior Claims Examiner.

Job Responsibilities:
Specific duties include but not limited to the below:
  • Investigate, evaluate and resolve Healthcare claims
  • Develop and implement a strategy to resolve matters of liability and damages of a particular case
  • Analyze coverage, liability and damages for purposes of assessing and recommending reserves
  • Prepare and present written and oral reports to senior management setting forth all issues influencing evaluation and recommending reserves
  • Manage excess accounts and perform audits
  • Identify and assess coverage issues and draft coverage position letters
  • Maintain contact with the insured, underwriter, primary adjuster, counsel retained by primary carrier and the broker
  • Make decisions whether to retain monitoring counsel, request tender of defense from primary or proceed with the litigation utilizing counsel retained by the primary
  • Retain counsel when necessary and direct counsel in accordance with resolution strategy
  • Attend mediations, trials, and other proceedings relevant to the resolution of the matter
  • Travel to and from such locations within the United States
  • Select and utilize structure brokers
  • Process invoice and indemnity payments
Required Skills/Experience:
  • 5 years of working experience supporting commercial accounts for Healthcare claims including claims
  • Proper & active adjuster licensing in all applicable states
  • Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
  • Strong time management and organizational skills
  • Ability to take part in active strategic discussions
  • Ability to work well independently and in a team environment
  • Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
  • Willing and able to travel 10%
Education:
  • Bachelor’s degree; Juris Doctorate degree preferred
  • For individuals assigned or hired to work in , the base salary range is $107,900.00/Yr. to $145,700.00/Yr. as of the time of posting. Position is incentive eligible.
  • Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above range may be modified in the future
  • Click here to learn more on available benefits
The Company:
Arch Insurance is a global insurer offering our clients superior coverage and service. We embody the Arch guiding principle of focusing on retaining experienced and talented employees to differentiate us from the rest of the pack. Our group operates from offices in the US, Canada, Bermuda, UK, and Australia, providing specialty risk solutions to clients worldwide across a wide range of industries. With nearly 20 years of operating history and strong financial ratings, our track record remains solid.

Arch Insurance employs a disciplined underwriting approach and prudent risk selection across all types of business. Our mission is to provide our insureds with superb coverage and claims handling through careful and diligent underwriting of risks and business-friendly solutions. Across our global operations, Arch Insurance employees are ready to meet your needs with professionalism and excellence.

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