Senior Commercial Auto Claims Examiner | Remote

Remote, USA Full-time
Our client is seeking to add a Commercial Auto Claims Examiner. This individual will be responsible for handling moderate to complex Commercial Auto claims including PIP/No-Fault claims arising from commercial auto losses, with a primary focus in Pennsylvania. The ideal candidate will have strong experience managing moderate to complex PIP claims, reviewing medical documentation, determining coverage, and negotiating equitable settlements in compliance with state regulations. This position offers the flexibility to work remotely from Philadelphia, PA. Responsibilities: • Investigate, evaluate, and resolve Commercial Auto, PIP, and No-Fault claims with a focus on compliance with Pennsylvania state laws and regulations. • Determine coverage, assess liability, establish and maintain reserves, and negotiate settlements within authority limits. • Review, analyze, and approve medical reports, treatment plans, IMEs, and invoices to ensure necessity, reasonableness, and alignment with state guidelines. • Communicate effectively with claimants, insureds, attorneys, and medical providers to achieve timely, fair, and compliant resolutions. • Collaborate with defense counsel and clients to develop effective litigation and resolution strategies. • Maintain detailed documentation and ensure claim coding accuracy in line with internal and regulatory standards. • Prepare detailed reports and responsive correspondence outlining claim findings, recommendations, and settlement rationale. • Provide mentorship and technical support to junior claims staff as needed. Requirements: • 3 to 7+ years of Commercial Auto or No-Fault (PIP) claims handling experience, preferably in Pennsylvania. • Strong understanding of Pennsylvania No-Fault/PIP laws and regulations. • Excellent verbal and written communication skills with the ability to negotiate and manage complex claims. • Highly organized, detail-oriented, and self-motivated with strong analytical and time management skills. • Ability to work independently in a remote environment. Salary/Benefits: • $80,000 to $90,000 depending on experience • Remote position based in Philadelphia, PA • Competitive Medical, Dental, and Vision coverage • Employer match 401(k) plan • Generous PTO benefits
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