Claims Examiner Job at Sunrise Systems, Inc., Jersey City, NJ

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  • Sunrise Systems, Inc.
  • Jersey City, NJ

Job Description

Job Title: Claims Examiner - 3

Location: Jersey City, NJ 07302

Duration: 6 Weeks with potential to extend

Position Type: Hourly contract Position (W2 only)

• Hybrid work model: 4 days in-office, 1 day remote.

• Standard hours: 9:00 AM – 5:00 PM, with a 30-minute lunch break.

Position Summary

The Claims Examiner is responsible for managing a portfolio of complex casualty claims, including those involving intricate coverage issues and Long Tail Exposure (LTE) claims that span multiple policy periods or involve class action litigation. This role requires expertise in handling claims such as concussion/head injury, abuse and molestation, chemical/toxic/environmental exposures, and claims potentially triggering Personal and Advertising Injury coverage under Commercial General Liability, Umbrella, and Excess policies.

The position demands a high level of technical competence, litigation management skills, and the ability to navigate sensitive and high-exposure claims while maintaining professionalism and compliance with company standards.

Key Responsibilities

  • Claims Management:
  • Investigate, evaluate, and resolve complex casualty claims with potential long-term exposure.
  • Draft and issue coverage position letters and maintain accurate documentation in claim files.
  • Respond promptly and professionally to inquiries from policyholders, brokers, and internal business partners.
  • Litigation Oversight:
  • Manage coverage litigation and arbitration related to assigned claims.
  • Direct and oversee outside counsel in coverage disputes, ensuring alignment with company strategy.
  • Develop litigation and resolution strategies, manage discovery requests, and participate in depositions, mediations, and trials as necessary.
  • Collaboration & Communication:
  • Work closely with internal stakeholders to provide updates and recommendations on claim status and litigation progress.
  • Maintain strong relationships with clients and business partners, delivering exceptional customer service.

Required Skills & Competencies

  • Strong organizational skills with the ability to manage multiple complex claims simultaneously.
  • Excellent written and verbal communication skills, including drafting legal and coverage-related documents.
  • Effective negotiation and interpersonal skills for managing sensitive claims and litigation.
  • Ability to work independently in a complex operating environment, demonstrating sound judgment and issue-spotting capabilities.
  • Comfort and willingness to handle claims involving abuse, sexual molestation, and other sensitive exposures.

Education & Experience

  • Minimum 5 years of experience as a licensed claims professional with specialized expertise in:
  • Litigation management
  • Complex coverage issues
  • High-exposure and/or long-term exposure claims
  • Coverage litigation
  • Law degree preferred, but not required.

Job Tags

Hourly pay, Contract work, Work at office, Remote work,

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