Sr Claims Examiner (TPA Oversight)

About the role

Seeking a highly skilled and experienced Senior Claims Examiner to join a growing TPA Oversight team. In 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 opportunity to join a stable and growing organization with a unique business model and a supportive, flexible work environment.

Responsibilities

• 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.

Requirements

• 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.
• Bachelor’s degree preferred, but not required.

Pay

Base Salary: $95,000 - $135,000 per year (depending on experience)

Annual Bonus: Discretionary, averaging around 10%

Benefits

• Comprehensive benefits package, including health, dental, and vision insurance
• Flexible and remote work environment