Health Insurance Tpa Jobs (NOW HIRING)

Title:

Company:

Job Category:

Job Description:

About Everest:

Everest is a global leader in risk management, rooted in a rich, 50+ year heritage of enabling businesses to survive and thrive, and economies to function and flourish. We are underwriters of risk, growth, progress and opportunity. We are a global team focused on disciplined capital allocation and long-term value creation for all stakeholders, who care deeply about our impact on communities and the wider world.

Job Summary:

Everest Insurance, a member of Everest Re Group, Ltd., has an opportunity for an experienced claims professional or attorney to join our Auto and GL TPA Oversight - Casualty Claims team in Warren, NJ, New York, NY or Philadelphia, PA. This individual will handle TPA Oversight and quality assessment for general liability and commercial auto claims.
This is a hybrid position working 3 days in office, 2 remote.

Responsibilities include but not limited to:

• Ensure compliance with Everest TPA Claim Handling Protocols

• Direct and report on focused claim reviews and file audits

• Maintain active diary system

• Actively manage and resolve claims when 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 identified within quality reviews

• 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, Education & Experience:

• 6-8 years of claims handling experience or related legal experience

• Past supervision experience

• B.A. or B.S. required

• Strong analytical and organizational skills

• Excellent verbal and written communication skills

• Strong negotiation and investigation skills

• Strong computer use skills across multiple claim system platforms

• 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

• Ability to compose summary reports of quality review findings

• Ability to obtain vendor compliance to Everest claim department standards

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

The base salary range for this position is $120,000 - $150,000 annually. The offered rate of compensation will be based on individual education, experience, qualifications and work location. All offers include access to a variety of benefits to employees, including health insurance coverage, an employee wellness program, life and disability insurance, 401k match, retirement savings plan, paid holidays and paid time off (PTO).
#LI-Hybrid
#LI-KG1

What if I don't meet every requirement? At Everest we are dedicated to building an inclusive and authentic workplace. So, if you are excited about this role but your past experience doesn't align perfectly with every element in the job description, we still encourage you to apply. You may be just the right candidate for this or other roles. Please let us know if you need any accommodations throughout the application or interview process.

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. Clickhereto learn more about our culture.

• Our Valuesare 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. Inclusion and Belonging.
• Our Colleague Behaviorsdefine 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:

Time Type:

Primary Location:

Additional Locations:

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.

Everest U.S. Privacy Notice | Everest (everestglobal.com)