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Showing: 1 Claims Examiner jobs in Philadelphia, Pennsylvania
Claims Examiner
Spectraforce
Philadelphia, Pennsylvania

a day ago

Job Description

Job Title: Claims Examiner
Location:
Jersey City, NJ (Alternate locations, Philadelphia, PA, New Haven, CT)
Duration: 1.5 months Assignment
Shift/Hours: 40hours/week, M to F, 9:00 AM – 5:00 PM, with a 30-minute lunch break.
Work Model: 4 days in-office, 1 day remote.
 
Summary:
  • The Claims Examiner is responsible for managing a portfolio of complex casualty claims, including those involving intricate coverage issues and Long Tail Exposure (LTE) claims that span multiple policy periods or involve class action litigation.
  • This role requires expertise in handling claims such as concussion/head injury, abuse and molestation, chemical/toxic/environmental exposures, and claims potentially triggering Personal and Advertising Injury coverage under Commercial General Liability, Umbrella, and Excess policies.
  • The position demands a high level of technical competence, litigation management skills, and the ability to navigate sensitive and high exposure claims while maintaining professionalism and compliance with company standards.
Key Responsibilities:
Claims Management:
  • Investigate, evaluate, and resolve complex casualty claims with potential long-term exposure.
  • Draft and issue coverage position letters and maintain accurate documentation in claim files.
  • Respond promptly and professionally to inquiries from policyholders, brokers, and internal business partners.
Litigation Oversight:
  • Manage coverage litigation and arbitration related to assigned claims.
  • Direct and oversee outside counsel in coverage disputes, ensuring alignment with company strategy.
  • Develop litigation and resolution strategies, manage discovery requests, and participate in depositions, mediations, and trials as necessary.
 Collaboration & Communication:
  • Work closely with internal stakeholders to provide updates and recommendations on claim status and litigation progress.
  • Maintain strong relationships with clients and business partners, delivering exceptional customer service.
Required Skills & Competencies:
  • Strong organizational skills with the ability to manage multiple complex claims simultaneously.
  • Excellent written and verbal communication skills, including drafting legal and coverage-related documents.
  • Effective negotiation and interpersonal skills for managing sensitive claims and litigation.
  • Ability to work independently in a complex operating environment, demonstrating sound judgment and issue-spotting capabilities.
  • Comfort and willingness to handle claims involving abuse, sexual molestation, and other sensitive exposures.
 Education & Experience:
  • Minimum 5 years of experience as a licensed claims professional with specialized expertise in:
  • Litigation management
  • Complex coverage issues
  • High-exposure and/or long-term exposure claims
  • Coverage litigation
  • Law degree preferred but not required.
 
Applicant Notices & Disclaimers
  • For information on benefits, equal opportunity employment, and location-specific applicant notices, click here
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 42.23/hr.

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