Abrar Admin

PMA Companies

<div>This is a senior level role focusing on claims brought against lawyers and law firms involving Lawyers Professional Liability (LPL) policies, from first notice to conclusion, with a range of severity and complexity from low to high.

Job Responsibilities
<ul>
<li>Review and document activity for assigned claims, including coverage evaluation, investigation, and consideration of multiple factors to assess potential liability and exposure</li>
<li>Develop working knowledge of policy forms, industry trends, and issues common to lawyers professional liability insurance and claims</li>
<li>Regularly identify and appropriately address relevant coverage issues</li>
<li>Draft insurance coverage correspondence and reports</li>
<li>Maintain professional relationships with internal and external audiences</li>
<li>Identify and refer files necessitating escalated review as appropriate to claims management</li>
<li>Develop action plans on assigned files to secure appropriate and timely resolution</li>
<li>Negotiate and settle claims with appropriate oversight by the claims management</li>
<li>Review, evaluate, request, and assign timely and appropriate reserves from file inception to resolution with appropriate oversight by claims management</li>
<li>Assign, coordinate, and manage outside counsel and vendors with appropriate claims management oversight</li>
<li>Review and audit attorney and vendor invoices consistent with Company guidelines</li>
<li>Independently conduct prompt and thorough investigation of low to high severity claims and evaluate coverage, liability, and damages throughout the life of a claim</li>
<li>Independent drafting of coverage related correspondence, internal reports, and reports to reinsurers</li>
<li>Participate in mediations and settlement negotiations to resolve claims, including higherseverity claims, with minimal oversight</li>
<li>Thoughtful, concise, and effective written and verbal communication with claims management and underwriting partners regarding significant claims, reserve recommendations, claim related trends, and industry developments with minimal oversight</li>
<li>Demonstrate leadership visibility and engagement with employees, claims management, underwriting partners through regular and meaningful interactions or meetings</li>
<li>May work with claims management and other internal and external partners to develop and implement procedures to improve claim workflow efficiency while preserving process controls</li>
<li>Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.</li>
</ul>Requirements:
<ul><li>Juris Doctor degree from an accredited law school</li>
<li>Minimum 10 years of relevant insurance, claims-related, or law firm experience preferred</li>
<li>Obtain adjuster license(s) or agree to obtain adjuster license(s) and additional training as necessary or required to complete claims handling responsibilities with moderate training, mentorship, and oversight by claims management</li>
<li>Exemplary analytical, interpretive, problem-solving, and critical thinking skills with ability to make sound decisions and effectively evaluate and resolve complex or challenging business problems</li>
<li>Strong situational awareness, understanding the context and implications of a decision</li>
<li>Exemplary writing and presentation skills with ability to convey complex technical information</li></ul></div>

Corporate Claims Consultant

<div>Job Description:

As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.

Responsibilities:
<ul>
<li>Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature</li>
<li>Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable)</li>
<li>Alert Supervisor and Special Investigations Unit to potentially suspect claims</li>
<li>Ensure timely denial or payment of benefits in accordance with jurisdictional requirements</li>
<li>Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure</li>
<li>Negotiate claims settlements with client approval</li>
<li>Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition</li>
<li>Work collaboratively with PMA nurse professionals to develop and execute return to work strategies</li>
<li>Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome</li>
<li>Maintain a working knowledge of jurisdictional requirements and applicable case law for each state serviced</li>
<li>Demonstrate technical proficiency through timely, consistent execution of best claim practices</li>
<li>Communicate effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues</li>
<li>Provide a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions</li>
<li>Authorize treatment based on the practiced protocols established by statute or the PMA Managed Care department</li>
<li>Assist PMA clients by suggesting panel provider information in accordance with applicable state statutes.</li>
<li>Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.</li>
</ul>
#LI-Remote
Requirements:
Requirements:
<ul>
<li>CA License and SIP designation required; Must reside in CA</li>
<li>Bachelor's degree, or four or more years of equivalent work experience required in an insurance related industry required</li>
<li>At least 3-5 years' experience handling lost time workers compensation claims required; past experience with CA jurisdiction is required</li>
<li>Associate in Claims (AIC) Designation or similar professional designation desired.</li>
<li>Active license required or ability to obtain license within 90 days of employment in mandated states.</li>
<li>Familiarity with medical terminology and/or Workers' Compensation</li>
<li>Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously</li>
<li>Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details</li>
<li>Strong verbal, written communication skills and customer service skills</li>
<li>Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint.</li>
<li>Ability to travel for business purposes, approximately less than 10%.</li>
</ul>
PMA is providing applicants with the anticipated wage range for this position in compliance with state regulations. The wage range for this role is $75,000 to $101,000. Wage ranges are based on national market data and may cover a wide range of geographies. Applicants may be paid above, within or below this range based on a variety of factors.</div>

Senior Claims Specialist - Workers Compensation

<div>Job Description:

Investigates, evaluates, reserves and resolves Commercial Automobile, First Party Property and General Liability claims for self-insured and unbundled clients. Provides a superior level of customer service to internal and external business partners. Administers and resolves claims for TPA clients in a timely manner and in accordance with client, company and regulatory guidelines.

Responsibilities:
<ul>
<li>Promptly investigates all assigned claims for coverage, liability, damages, subrogation and contribution. Ensures timely disposition of all claims in accordance with client, regulatory and statutory requirements.</li>
<li>Within granted authority, establishes appropriate loss and expense reserves with documented rationale. Maintains and adjusts reserves over the life of the claim to reflect changes in exposure. Notifies appropriate claims management and clients when exposure exceeds authority. Negotiates claims resolution within granted authority.</li>
<li>Establishes and executes appropriate action plans for claim resolution including loss cost management while achieving appropriate balance between allocated expense and loss outcome.</li>
<li>Works collaboratively with the client and internal and external business partners in investigating and reaching appropriate disposition of all claims.</li>
<li>Selects and manages service vendors to achieve appropriate balance between allocated expense and loss outcome.</li>
<li>Maintains a working knowledge of regulatory and jurisdictional requirements for assigned claims territory.</li>
<li>Demonstrates technical proficiency through timely, consistent execution of best claim practices and established claims handling guidelines.</li>
<li>Communicates effectively with internal and external customers on claims and account issues. Provides a high degree of customer service.</li>
<li>Maintain and manage a diary system and claim pending to efficiently and effectively resolve all claims.</li>
<li>Potential local travel.</li>
<li>Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.</li>
</ul>
#LI-Remote
Requirements:
Requirements:
<ul>
<li>FL and/or TX License required plus NY license highly desired or ability to obtain NY license.</li>
<li>Bachelor's' degree and a minimum of 3 years of progressively responsible experience handling Commercial Automobile, First Party Property and General Liability claims required.</li>
<li>Experience handling PA, NJ and DE claims.</li>
<li>Familiarity with coverage, negligence principles, investigation and negotiation techniques.</li>
<li>Obtains and maintains state adjusting licenses, as needed. Ensures that all state-required Continuing Education Credits are obtained as needed to maintain license.</li>
<li>Strong organizational skills and detail oriented.</li>
<li>Ability to work independently, handle multiple tasks simultaneously and exercise good judgment.</li>
<li>Working knowledge of Auto, Liability and Property claims handling practices.</li>
<li>Excellent verbal and written communication skills.</li>
<li>Excellent customer service skills.</li>
<li>Computer literacy, including working knowledge of MS Office including Word, Excel and PowerPoint.</li></ul></div>

Claims Specialist - Commercial Auto, Property and General Liability

<div>As a member of our Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.

Responsibilities:
<ul>
<li>Promptly investigates all assigned claims with minimal supervision, including those of a more complex nature</li>
<li>Determines coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable)</li>
<li>Alerts Supervisor and Special Investigations Unit to potentially suspect claims</li>
<li>Ensures timely denial or payment of benefits in accordance with jurisdictional requirements</li>
<li>Within granted authority, establishes appropriate reserves with documented rationale, maintains and adjusts reserves over the life of the claim to reflect changes in exposure</li>
<li>Negotiates claims settlements within granted authority</li>
<li>Establishes and implements appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition</li>
<li>Works collaboratively with PMA nurse professionals to develop and execute return to work strategies</li>
<li>Selects and manages service vendors to achieve appropriate balance between allocated expense and loss outcome</li>
<li>Maintains a working knowledge of New York jurisdictional requirements and applicable case law for each state serviced</li>
<li>Demonstrates technical proficiency through timely, consistent execution of best claim practices</li>
<li>Communicates effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues</li>
<li>Provides a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions</li>
<li>Authorizes treatment based on the practiced protocols established by statute or the PMA Managed Care department</li>
<li>Assists PMA clients by suggesting panel provider information in accordance with applicable state statutes.</li>
<li>Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.</li>
</ul>
#LI-Remote
Requirements:
<ul><li>Bachelor's degree and/or four or more years of equivalent work experience required in an insurance related industry required</li>
<li>CA jurisdiction experience required; AX experience is a plus</li>
<li>Associate in Claims (AIC) Designation or similar professional designation desired</li>
<li>License required or ability to obtain license within 90 days of employment in mandated states</li>
<li>Familiarity with medical terminology and/or Workers' Compensation
</li><li>Working knowledge of Workers Compensation regulations, preferably jurisdiction-specific</li>
<li>Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously</li>
<li>Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details</li>
<li>Strong verbal, written communication skills and customer service skills gained through previous work experience</li>
<li>Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint</li>
<li>Ability to travel for business purposes, approximately less than 10%.</li></ul></div>

Claims Specialist

Join PMA Companies and explore 4   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

PMA Companies

About Company

Corporate Claims Consultant

Senior Claims Specialist - Workers Compensation

Claims Specialist - Commercial Auto, Property and General Liability

Claims Specialist