4 general liability claim representative jobs found in Trenton

Join NJM Insurance Group’s Medical Claim Services (MCS) team as a Business Process Operations Analyst, where you will play a key role in driving process improvement and support business continuity and technology initiatives. The primary purpose of this role is to provide consistent support to business users in both technology and non-technology operations, including incident management, production support, and departmental activities and assist in the seamless operationalization of new processes and technology solutions, ensuring smooth transitions and effective change management for business users. This position requires subject matter expertise (SME) in Personal Injury Protection (PIP), Workers’ Compensation, and/or General Claims. The ideal candidate will have a strong understanding of current business processes and the ability to identify, design, and implement effective improvements. Essential Duties and Responsibilities: Support Strategic Plan, Leadership, and...

The overall responsibility of this position is to consistently execute on the Company’s mission, vision, and values, leading customer service approach, and claims business model to provide best outcomes on complex/high severity claims. The Complex Claims Specialist, Senior will be responsible for contacting all parties involved in the claim, gathering, and securing all necessary information to effectively evaluate the claim, and implement an action plan to manage the claim. The Complex Claims Specialist, Sr will work with and communicate to NJM policyholders, injured workers, medical providers, the NJM Medical Services Administration Department, Special Investigation Unit, WC Legal Staff, other departments within NJM, and vendors as needed. This is a senior level position in the Complex Claims track that will require minimal supervision and guidance to accomplish the goals and objectives of the role. Essential Duties and Responsibilities: Review, investigate, and analyze...

Our Commercial Lines department is seeking a Premium Auditor with strong organizational and time management skills. The field auditor will be responsible for performing audits of Commercial Lines policies in accordance with company, industry and government rules and regulations in order to establish appropriate classifications, exposures, and basis of premium for each insured in. This position will cover Middlesex, Somerset and Union County. Essential Duties and Responsibilities: Conducting Premium Audits on Commercial Lines policies, which can include multi-state and/or multi-line policies. Performing a thorough review of the policyholder’s records to identify the insured’s exposures to the coverage provided. Verifying employer classes, claimant information, tax identification numbers, and payroll for the audit period, as well as other appropriate information required to ensure a complete and thorough audit. Documenting and processing the audit to explain deviations...

Our West Trenton General Claims Legal Department is seeking a motivated, detail-oriented individual for a PIP Appeal and Litigation (PAL) Processor Processor role. Reporting to the designated supervisor and accountable for efficiently collecting and organizing pertinent information of appeal, litigation/arbitration process for adjusters and defense counsel. Essential Duties and Responsibilities: Receive, analyze, and process complaints/arbitration demands, create litigation matters, and assign to appropriate PAL adjuster for review. Assist PAL Adjusters and supervisors by accurately entering pertinent information into Claim Center, OnBase, and AgilePoint.  Provide support as needed to FNOL First Notice of Loss (FNOL) Dept in taking claims. Review the investigation file material, select appropriate information, and electronically send to defense firms. Provide support to PAL Adjusters with document requests and information needed for pertinent matters. Process monthly...