Jobs
>
Philadelphia

    Senior Claims Examiner - Philadelphia, United States - Septa

    Septa
    Septa Philadelphia, United States

    6 days ago

    Default job background
    Description
    Secure your FUTURE with SEPTA today

    The Southeastern Pennsylvania Transportation Authority (SEPTA) is the sixth largest transportation system in the United States, with a vast network of fixed route services including bus, subway/elevated, trackless trolley, light rail, and commuter rail serving a 2,200 square mile service region. SEPTA has become an integral force in the economic success of the Philadelphia region, providing an efficient and reliable source of transportation.

    We are seeking candidates for the position of Senior Claims Examiner in the Legal - Video, Intake and Claims.

    Opening Date: 06/12/2024

    Closing Date: 06/26/2024

    Job Grade: SAM 40

    Salary Range: Min: $79, Mid: $99, Max: $119,314.00

    OVERALL DESCRIPTION

    Manages Office of General Counsel (OGC) resources and collaborates with others to ensure that required information to properly manage claims is part of claims file. Investigates and evaluates tort liability claims, working with team of OGC professionals, outside counsel and experts to categorize, reserve and strategize claim resolution toward planned resolution.

    SPECIFIC RESPONSIBILITIES
    • Primary responsibility for managing a large inventory of liability claims from first notice of claim through final resolution.
    • Collaborates with Intake/Intel professionals to ensure that all assigned liability claims files contain the information required to properly and completely investigate and evaluate claims.
    • Identifies and evaluates coverage issues.
    • Conducts, coordinates, and directs investigation into loss facts and extent of third party damage.
    • Manages reserves adequacy throughout the life of the claim. Alerts upper management of cases with high exposure, legal changes, and jurisdictional value. Professionally presents cases to senior leadership for those of significant value.
    • Prepares detailed and comprehensive initial reports and follow up reports with concise and effective action plans designed to move the claim towards resolution.
    • Collaborates with defense counsel and management team to facilitate positive claim resolution.
    • Manages outside litigated claims by developing litigation plan with outside counsel and ensure service requirements are met; Attends depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed; Tracks and controls legal expenses to assure cost-effective resolution.
    • Documents and communicates all claim activity timely and effectively, and in a manner that facilitates a fair and appropriate outcome.
    • Settles claims consistent with planned resolution and in accordance with authority.
    ADDL / DISCIPLINE RESPONSIBILITIES
    • Analyzes and evaluates medical records, diagnostic testing, and medical bills to determine if injuries and treatment are causally related. Completes and submits authority request report. Negotiates and settles claims with claimant's counsel and unrepresented claimants within provided authority.
    • Identifies potential suspicious claims and refers to the Office of the Inspector General. Identify opportunities to tender the claim to third party vendors by reviewing contracts/certificate of insurance.
    • Coordinates with property damage unit to identify and pursue recovery/subrogation potential.
    • Manages the litigation process for outside counsel and adhere to litigation guidelines to include budget, bill review and payment. Attends settlement conferences, court hearings, arbitrations and trial as required.
    • Provides outstanding customer service and with internal and external customers in the adjustment of the claims.
    • Handles claims consistent with SEPTA policies, procedures and "best practices" and also, in accordance with any statutory, regulatory and ethics requirements.
    • Performs other duties as required/assigned.
    QUALIFICATIONS AND EXPERIENCE
    • Bachelor's Degree from an accredited college/university required plus five (5) years of experience handling General Liability claims required which includes a minimum of two (2) years of handling complex and litigated claims.
    • An equivalent combination of experience and education (i.e., two (2) years of related experience, equating to one (1) year of formal post high school education) may be considered in lieu of the above requirements.
    • Knowledge of PA Motor Vehicle Financial Responsibility Law and PA Tort Law and PA Rules of Civil Procedure required.
    • Excellent written, verbal and interpersonal skills required.
    • Personal Computer experience including knowledge of Microsoft Outlook, Word and Excel is required.
    • Excellent customer focus to proactively identify and understand customer needs required.
    • Demonstrated decision-making skills, including the ability to recognize, analyze and improve claims' management practices required.
    • Ability to think critically, identify and solve problems, plan and organize activities and negotiate effectively required.
    BENEFITS

    SEPTA offers a comprehensive benefits and retirement program:
    • Medical - Minimal annual premium contribution
    Benefit plans with No Employee annual premium contribution:
    • Prescription
    • Dental
    • Vision
    Additional benefits we offer:
    • Defined Benefit Pension Plan
    • Voluntary Governmental 457B Deferred Comp Plan, with available Financial Advice and Planning Services
    • Life Insurance
    • Paid Parental Leave
    • Tuition Reimbursement
    • SEPTA Transportation Pass - FREE travel on all SEPTA modes of transportation
    • SEPTA employees qualify for the Public Service Loan Forgiveness (PSLF) program
    • Generous Vacation Allowance
    • Dependent Care Flexible Spending Account
    SEPTA is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

    Nearest Major Market: Philadelphia
  • Sunrise Systems

    Claims Examiner

    2 weeks ago

    Sunrise Systems Philadelphia, United States

    Job Title: Claims Examiner · Location: Philadelphia, PA 19106 · Duration: 6 months · Position Type: Hourly contract Position (W2 only) · Note:Job Schedule--Hybrid Role 3/2 Schedule with 3 days in office-Monday/Wed/Thurs · Job Hours-8:00am-6:00pm flexible-to be discussed with mana ...

  • The Ladders

    Senior Claims Examiner

    2 days ago

    The Ladders Philadelphia, United States

    Secure your FUTURE with SEPTA today · The Southeastern Pennsylvania Transportation Authority (SEPTA) is the sixth largest transportation system in the United States, with a vast network of fixed route services including bus, subway/elevated, trackless trolley, light rail, and c ...

  • Philadelphia Insurance Companies

    Claims Examiner

    1 week ago

    Philadelphia Insurance Companies Bala-Cynwyd, United States

    **Marketing Statement** · Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are national ...

  • Reliance Standard

    LTD Claims Examiner II

    1 week ago

    Reliance Standard Philadelphia, United States

    Job Responsibilities and Requirements · KEY RESPONSIBILITIES · *other duties as assigned* · Obtains and analyzes information to make claim decisions and payments on LTD, Voluntary disability and Waiver of Premium claims. The goal of the position/role is to consistently render ...

  • A-G Administrators

    Claim Examiner

    1 week ago

    A-G Administrators Berwyn, United States

    A-G Administrators LLC designs, markets and underwrites specialty sports, accident, and general liability insurance products. We have been in operation since 1983 and are nationally recognized as a leader in the sports insurance industry. · Job Summary · The Claim Examiner is r ...

  • A-G Administrators LLC

    Claim Examiner

    2 weeks ago

    A-G Administrators LLC Berwyn, United States

    Job Description · Job DescriptionA-G Administrators LLC designs, markets and underwrites specialty sports, accident, and general liability insurance products. We have been in operation since 1983 and are nationally recognized as a leader in the sports insurance industry. · Job Su ...

  • Arch Capital Group Ltd.

    Senior Claims Examiner, D&O

    2 days ago

    Arch Capital Group Ltd. Philadelphia, United States

    Specific duties include but not limited to the below:Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary as well as review coverage counsel's opinion letters and analysis. Develop and impl Claims, Examiner, Senior, Ins ...

  • Reliance Standard

    Claims Examiner NY DBL/PFL

    1 week ago

    Reliance Standard Philadelphia, United States

    Job Responsibilities and Requirements · KEY RESPONSIBILITIES · *other duties as assigned* · The Claims Examiner I obtains and analyzes data for thorough, fair, objective, and timely adjudication of NY State Short Term Disability and Paid Family Leave claims. The goal of the po ...

  • Vanguard Adjusters Group

    CAT Claims Examiners

    1 day ago

    Vanguard Adjusters Group Woodbury, United States

    Vanguard is defined in the Oxford Dictionary as a group of people leading the way in new developments or ideas. Vanguard Claims Administration is no different. Whether you are a client, an employee or a key vendor, you will find your exposure to the VANGUARD team to be a refreshi ...

  • Arch Capital Group

    Senior Claims Examiner, New York Labor Law

    2 weeks ago

    Arch Capital Group Philadelphia, United States Full time

    Job Summary · The Claims Division is seeking a team member to join the Casualty Team as Senior Claims Examiner. In this role, the responsibilities include but not limited to actively manage a caseload and provide oversight to third-party administrator claims handlers for commerc ...

  • Intact Insurance

    Surety Claims Examiner

    1 week ago

    Intact Insurance Blue Bell, United States

    Job Description · We currently have an opportunity for a Surety Claims Examiner to join our Surety team in our Blue Bell, PA offices or remotely nationwide. This position is responsible for handling and resolving complex and/or specialized assigned claims through investigation, ...

  • Arch Capital Group Ltd.

    Senior Claims Examiner, New York Labor Law

    4 weeks ago

    Arch Capital Group Ltd. Philadelphia, United States

    With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Ena ...

  • J.F. Terry Associates, Inc.

    Insurance Claims Examiner

    2 weeks ago

    J.F. Terry Associates, Inc. Newtown Square, United States

    **IMMEDIATE NEED for Insurance Claims Professional. Salary to be determined based on experience.** · Founded in 1969, J.F. Terry Associates is a multi-line insurance claims adjusting firm serving the Mid-Atlantic states including New England, Florida and California. We handle the ...

  • Sedgwick Claims Management Services

    Claims Adjuster/Examiner Liability

    3 weeks ago

    Sedgwick Claims Management Services King of Prussia, United States

    To analyze mid- and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements. ESSEN Claims, Adjuster, Examiner, L ...

  • Butler Weihmuller Katz Craig

    First And/or Third Party Coverage Associate

    1 week ago

    Butler Weihmuller Katz Craig Philadelphia, United States

    AV-rated, civil litigation firm has an opening in its Philadelphia office for an insurance coverage litigator (first and/or third party). The ideal candidate will have 2-5 years of litigation experience. Experience handling insurance defense matters is a plus. The position will i ...

  • Temple Health – Temple University Health System

    Revenue Cycle Analyst

    1 week ago

    Temple Health – Temple University Health System Philadelphia, United States

    Location: Cheltenham, PA · Hours: Day, HYBRID after Training · Job Summary · Responsibilities include all aspects of Revenue Cycle system support including performance improvement, development, documentation, testing, training and upgrades. Assists management in examining proces ...

  • The Jacobson Group

    Workers Compensation Unit Stat Specialist

    2 weeks ago

    The Jacobson Group Philadelphia, United States

    Our client, the world's largest publicly traded property and casualty insurance company, is looking to bring on two Lost Time Claims Examiners for a one year assignment at their offices in Philadelphia, PA on a hybrid basis. · Summary: · The main function of the WC Unit Stat Spe ...

  • Leonardo

    Associate General Counsel, Compliance

    1 day ago

    Leonardo Philadelphia, United States

    Leonardo Helicopters is a multinational company, producing helicopters deployed in more than 150 countries across the globe. Leonardo Helicopters' U.S. headquarters has been in Philadelphia since 1980 and is home to a world-class production facility, maintenance center, training ...

  • City of Philadelphia

    L&I Code Enforcement Inspector

    1 day ago

    City of Philadelphia Philadelphia, United States Full time

    The City of Philadelphia is seeking inspectors to join their dedicated and knowledgeable team at the Licenses and Inspections Department ensuring the public's safety by enforcing property codes. There are many pathways to qualify for this great opportunity. If you have two to thr ...

  • Independence Blue Cross

    Supervisor Claims Payment/Customer Service

    2 days ago

    Independence Blue Cross Philadelphia, United States

    Job responsibilities include: · • Participate in hiring and orientation of new employees. · • Perform Quality Assurance audits on trainees assigned to a specific service center under supervisors' control. Audits are done on 100% basis until a trainee has established an acceptab ...