Sr Claims Examiner (TPA Oversight)

Senior Claims Examiner (TPA Oversight)

Seeking a highly skilled and experienced Senior Claims Examiner to join a growing TPA Oversight this role you will oversee Third-Party Administrator (TPA) adjusters handling a variety of casualty claims including slip and falls premises liability bodily injury New York Labor Law and surety claims. This is an exciting opportunity to join a stable and growing organization with a unique business model and a supportive flexible work environment.

• Base Salary: $95000 - $135000 per year (depending on experience)
• Annual Bonus: Discretionary averaging around 10%
• Comprehensive benefits package including health dental and vision insurance
• Flexible and remote work environment

• Oversee TPA adjusters managing a variety of casualty claims ensuring compliance with company standards and best practices.
• Review and approve coverage tenders reservation of rights (ROR) letters and other claim-related documentation.
• Analyze data from TPAs and other departments presenting findings to management in a clear and concise manner.
• Collaborate with internal teams and external partners to ensure efficient and effective claims handling.
• Provide guidance and support to TPA adjusters on complex claims including those involving bodily injury and litigation.
• Monitor and evaluate TPA performance identifying areas for improvement and implementing corrective actions as needed.

• Minimum of 8 years of experience in Commercial General Liability claims handling.
• Professional liability or employment liability experience is required.
• Strong tenure in previous roles demonstrating stability and commitment.
• Experience handling claims involving bodily injury and litigation.
• Familiarity with New York Labor Law is a plus but not required.
• Must hold a Home State or Designated Home State adjuster license (company will assist with licensing in additional states as needed).
• Prior experience with insurance carriers is required; a combination of carrier and TPA experience is preferred.
• Proficiency in drafting coverage tenders ROR letters and other claim-related correspondence.
• Strong skills in Microsoft Excel with the ability to analyze and present data effectively.
• Bachelors degree preferred but not required.

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