Claims Specialist I (TPA Oversight) at Everest Global Services, Inc. in Boston, Massachusetts

Job Description:

Title:
Claims Specialist I (TPA Oversight)


Company:
Everest Insurance Company


Job Category:
Claims


Job Description:



About Everest:

Everest Group, Ltd. (Everest), is a leading global reinsurance and insurance provider, operating for nearly 50 years through subsidiaries in North America, Latin America, the UK & Ireland, Continental Europe and Asia Pacific regions. Throughout our history, Everest has maintained its discipline and focuses on creating long-term value through underwriting excellence and strong risk and capital management. Our strengths include extensive product and distribution capabilities, a strong balance sheet, and an innovative culture. Our most critical asset is our people. We offer dynamic training & professional development to our employees. We also offer generous tuition/continuing education reimbursement programs, mentoring opportunities, flexible work arrangements, and Colleague Resource Groups.



About the Role:



The Auto and GL TPA Oversight - Casualty Claims team has an opportunity for an experienced claims professional to join as a Claims Specialist I. This is a hybrid role (3 days in office/2 days remote). This individual will handle TPA Oversight for general liability and commercial auto claims.



Role & Responsibilities (include but not limited to):

• Ensure compliance with Everest TPA Claim Handling Protocols.
  
  


• Perform focused claim reviews.
  
  


• Actively manage and resolve claims where appropriate.
  
  


• Participate in settlement conferences and mediation as needed.
  
  


• Participate in meetings with policyholders and brokers as needed.
  
  


• Analyze claims metrics including reserve accuracy, productivity, prompt communication; and expense management.
  
  


• Develop and execute on action plans to address deficiencies.
  
  


• Conduct regular meetings with TPA adjusters and managers to discuss trends and claim handling strategy.
  
  


• Develop and maintain relationships with underwriting groups and brokers/agents.
  
  


• Work with business partners to address customer service issues.
  
  

Qualifications:

• B.A. or B.S. or equivalent work experience.
  
  

Knowledge, Skills & Competencies:

• 2+ years of commercial claims handling experience.
  
  


• Experience with litigation management and bodily injury claims is required.
  
  


• Prior commercial TPA oversight experience is strongly preferred.
  
  


• Strong analytical and organizational skills.
  
  


• Excellent verbal and written communication skills.
  
  


• Strong negotiation and investigation skills.
  
  


• Ability to think strategically.
  
  


• Ability to influence others and resolve complex, disputed claims.
  
  


• In-depth knowledge of the litigation, arbitration, and trial process.
  
  


• Currently holds or readily can obtain all required adjuster licenses.
  
  


• Ability to identify and use relevant data and metrics to best manage claims.
  
  


• Collaborative mind-set and willingness to work with people outside immediate reporting hierarchy to improve processes and generate optimal departmental efficiency.
  
  


• Ability and willingness to present to senior management and to others in other group settings.
  
  


• Knowledge of the insurance industry, claims process and legal and regulatory environment.
  
  

Our Culture


At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Click here to learn more about our culture.

• 
  Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Diversity, Equity and Inclusion.
  
  


• 
  Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together.
  
  

All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve.


Type:
Regular


Time Type:
Full time


Primary Location:
Warren, NJ


Additional Locations:
Boston, MA, Chicago, IL - South Riverside, Hartford, CT, New York, NY, Philadelphia, PA


Everest is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex (including pregnancy), sexual orientation, gender identity or expression, national origin or ancestry, citizenship, genetics, physical or mental disability, age, marital status, civil union status, family or parental status, veteran status, or any other characteristic protected by law. As part of this commitment, Everest will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Everest Benefits at everestbenefits@everestglobal.com.


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