Job ID: 24-17398 Type: Regular Full-Time # of Openings: 1 Category: Insurance & Administration Mitchell International, Inc.
Overview
The Enlyte Family of Businesses
Mitchell | Genex | Coventry
Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth.
Responsibilities
You Must be in New Jersey and have New Jersey Workers' Compensation Claims Experience
Plans, directs and guides the activities of adjusters
Assists supervisor with tasks as assigned which could include; supervision of files, performing monthly SCORE audits, internal claim reviews, performing 1:1 performance meetings with staff, new claim set up and documentation, review and approve reserves, attend client meetings
Meets with the supervisor regularly to discuss any concerns or issues
Assists in hiring and training of new employees
Understands concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims toward resolution using Best Practices. •
Investigates all assigned claims for coverage, liability assessment and damages.
Interviews claimants and witnesses, establishes claim reserves, handles evidence, obtains evidence, obtains and interprets official reports, medical reports and claim forms, and attend/participate at mediation, trials or hearings. •
Negotiates and settles claims, sets reserves and manage litigation within client service parameters and authority levels by obtaining demands and making offers to claimants.
Attends client meetings and present PARs.
Documents plan of action in the claim system and sets appropriate diaries
Manages diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
Closes all files as appropriate in a timely and complete manner.
Maintains closing ratio as directed by management team. Attends/participates at mediation, trials or hearings.
Interacts with clients, claimants, attorneys, investigators, experts and other vendors perform other duties as directed
Qualifications
Associates or Bachelor’s degree, or five or more years of equivalent work experience required in an insurance/TPA or related industry;
At least 5-6 years of experience handling liability claims required; more experience may be required depending upon complexity of claim pending.
Leadership and supervisory related experience required
Completion of training courses internally and/or externally in all significant areas affecting claims handling and practices. Licenses, certifications, awards preferred.
