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Executive Claims Specialist, PIP, Remote

Role overview

Qualifications

  • 6+ years of progressively responsible PIP/no-fault claims experience
  • Extensive hands-on New Jersey, New York and/or Pennsylvania no-fault experience
  • Strong knowledge of medical management, coverage, treatment disputes, benefit denials and regulatory compliance
  • Bachelor’s degree required

Responsibilities

  • Provide senior-level technical oversight of PIP/no-fault claims administered by Third-Party Administrators
  • Serve as a subject matter resource for PIP, including coverage, medical benefits and treatment disputes
  • Evaluate coverage, benefit eligibility, priority of coverage and potential risk-transfer opportunities
  • Conduct targeted claim audits and quality reviews

Key facts

Hard skills

Other skills

  • Analytical Skills
  • Non-Verbal Communication

About the company

Crum & Forster logo

Crum & Forster

Insurance

Crum & Forster (C&F) is a leading national property & casualty insurance company with a large, diversified specialty platform. We protect businesses and organizations from the unpredictable nature of risk, giving them the confidence to take on new challenges and flourish in today’s increasingly complex and uncertain world. C&F is client-focused, creative, and flexible in delivering customized products and services. Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. Approaching $4 billion in written premium as of 2021, C&F enjoys a financial strength rating of “A” (Excellent) by A.M. Best. C&F is proud of its superior customer service platform and its claims and risk engineering services are recognized as among the best in the industry. Our most valuable asset is our people – 2500+ employees, and growing, in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning workplace and wellness awards. C&F is part of Fairfax Financial Holdings, a global organization with $23.8 billion in revenue as of 2021. For more information about Crum & Forster, please visit our website: www.cfins.com. Affiliated Companies: Seneca Insurance Company The Redwoods Group Travel Insured International Crum & Forster Pet Insurance Group

Company details

Company typeLarge
IndustryInsurance
Company size1001 - 5000

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Job description

Crum & Forster Company Overview:

Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.

Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.

C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.  For more information about Crum & Forster, please visit our website: www.cfins.com.

Job Description:

S&S Transportation & Sharing Economy is seeking an experienced Executive Claims Specialist – Personal Injury Protection / No-Fault to provide senior-level technical oversight of Personal Injury Protection (PIP) claims within our sharing economy program. This position will primarily support multiple states with New Jersey, New York and Pennsylvania no-fault experience strongly preferred. The ideal candidate is a seasoned PIP professional with strong technical judgment, litigation and arbitration experience, and the ability to partner effectively with Third-Party Administrators and other stakeholders to promote quality claim outcomes.  This is an oversight and technical leadership role rather than a traditional claim-production position.

What you will do for C&F:

  • Provide senior-level technical oversight of PIP/no-fault claims administered by Third-Party Administrators.
  • Serve as a subject matter resource for PIP, including coverage, medical benefits, treatment disputes, medical necessities, peer reviews, IMEs, denials and regulatory requirements.
  • Provide technical guidance on complex, disputed, litigated and arbitrated PIP matters.
  • Evaluate coverage, benefit eligibility, priority of coverage and potential risk-transfer opportunities.
  • Review claim handling for accuracy, timeliness, documentation and compliance with applicable statutory and regulatory requirements.
  • Partner with TPA claim professionals and leadership to address claim handling concerns, reinforce program expectations and identify opportunities for improvement.
  • Conduct targeted claim audits and quality reviews.
  • Evaluate reserve adequacy and provide technical recommendations on complex exposures.
  • Identify trends involving providers, litigation, claim handling, leakage, compliance and emerging exposures.
  • Coordinate with Legal, SIU, medical review vendors, defense counsel and other internal and external partners as appropriate.
  • Support enhancements to claim guidelines, workflows, reporting, training and quality controls.
  • Maintain awareness of legislative, regulatory and judicial developments affecting PIP/no-fault claims.

What you will bring to C&F:

  • 6+ years (8-10 preferred) of progressively responsible PIP/no-fault claims experience, including complex or technically advanced matters.
  • Extensive hands-on New Jersey, New York and/or Pennsylvania no-fault experience strongly preferred.
  • Strong knowledge of medical management, coverage, treatment disputes, benefit denials and regulatory compliance.
  • Significant PIP litigation and arbitration experience.
  • Experience with TPA oversight, carrier technical claims, quality assurance or similar program oversight preferred.
  • Commercial auto experience. Rideshare, transportation network company or sharing economy experience is a plus but not required.
  • Strong analytical, written and verbal communication skills.
  • Bachelor’s degree required. CPCU, AIC, SCLA, law degree or other relevant professional designation is a plus.
  • Occasional travel may be required.
What C&F will bring to you:
  • Competitive compensation package
  • Generous 401K employer match
  • Employee Stock Purchase plan with employer matching
  • Generous Paid Time Off
  • Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family’s wellness, including your physical, mental and financial wellbeing
  • A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
  • A dynamic, ambitious, fun and exciting work environment
  • We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community

At C&F you will BELONG

If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know

 For California Residents Only:  Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit https://www.cfins.com/onlineprivacypolicy/ca/noticeatcollection/  for more information.

Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws.  Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $64,700.00 to a maximum of $121,600.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee’s contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.

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Marcus Rivera

Chief Revenue Officer

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