Claims Representative 2

At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services, you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact.

About the role

Investigates, evaluates, disposes of, and settles the most complex and highest exposure claims with minimal supervision. This includes the investigation, determination, and evaluation of coverage, liability, and damages, and the setting of proper reserves in accordance with legal statutes, policy provisions, and company guidelines.

Hybrid Position: Must live near Egg Harbor Township, NJ
Monday - Friday 8:00 AM - 4:30 PM EST

Responsibilities

• Understand concepts of coverage, policy interpretation, exposure recognition, and liability determination to analyze and move claims toward resolution using Best Practices.
• Promptly investigate all assigned claims for coverage, liability assessment, and damages.
• Manage a claim pending of approximately 250 files, the majority of which are in litigation.
• Investigate claims by interviewing claimants and witnesses, establish claim reserves, handle evidence, obtain and interpret official reports, medical reports, and claim forms, and attend/participate at mediation, trials, or hearings.
• Negotiate and settle claims, set reserves, and manage litigation within client service parameters and authority levels by obtaining demands and making offers to claimants.
• May present evidence at legal proceedings.
• Direct appraisal and/or inspection of damaged property.
• Dispose of salvage and pursue subrogation when appropriate.
• Document plan of action in the claim system and set appropriate diaries.
• Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
• Close all files as appropriate in a timely and complete manner.
• Maintain closing ratio as directed by management team.
• Attend/participate at mediation, trials, or hearings.
• Routinely interact with clients, claimants, attorneys, investigators, experts, and other vendors.
• Perform other duties as required.

Requirements

• HS Diploma/GED equivalent.
• At least 2+ years of experience handling first-party property claims preferred; more experience may be required depending upon complexity of claim pending.
• Completion of training courses internally and/or externally in all significant areas affecting claims handling and practices.
• Licenses, certifications, awards preferred.
• Proficient with MS Excel and Word.
• Computer experience with related claims software.
• Excellent verbal and written communication skills.
• Excellent negotiation skills.
• Superior organizational and decision-making skills.
• Strong analytical and strategizing skills.
• Significant understanding of self-insured retention, excess, and reinsurance reporting.

Benefits

We’re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth, and self. These offerings include:

• Medical, Dental, Vision
• Health Savings Accounts / Flexible Spending Accounts
• Life and AD&D Insurance
• 401(k)
• Tuition Reimbursement
• An array of resources that encourage a lifetime of healthier living

Benefits eligibility may differ depending on full-time or part-time status.

Pay

The expected base pay for this position ranges from $18.45 - $21.00 hourly, and will be based on skills, experience, and education.