Claims Examiner, Sr. jobs in Trenton, NJ

Claims Examiner, Sr. reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner, Sr. studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner, Sr. determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner, Sr. occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Claims Examiner, Sr. typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)

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Claims Examiner
  • NJHA HEALTHCARE BUSINESS SOLUTIONS INC
  • Princeton, NJ FULL_TIME
  • The New Jersey Hospital Association is a not-for-profit trade organization committed to delivering support and services to the states hospitals, health systems and other healthcare providers. We share a collective goal of providing quality, affordable and accessible healthcare to the people of the Garden State. We are seeking a Claims Manager.

    Objective: Reviews routine unemployment insurance claims. Also reviews complex claims with input from senior PCM staff. In disputed claims conducts investigation and with input from senior staff determines if appeal is warranted and follows through on appeals process.

    Essential Job Functions:

    • Reviews initial monetary and non-monetary determinations to confirm that such determinations are consistent with information submitted by client and are appropriate with respect to state and federal statutes.
    • Based on information received from Division of Unemployment Insurance and from employer, advises employer whether or not appeal is warranted. If appeal is filed, follows through with the appeals process.
    • Establishes and maintains claim records to include posting and auditing charges and initiating protests on those charges to be in error.
    • Reviews penalties issued against clients based on review requests, cancellation, abatement or advises client to pay.
    • Provides NJ Department of Labor with wage and separation information on claims for clients for whom PCM is the addressee of record.
    • Contacts employer by letter, email, phone, fax, requesting wage and/or separation information.
    • Upon receipt of information, completes necessary unemployment form(s) and forwards to appropriate Local Unemployment Office.
    • Maintains electronic log of incoming UI forms to ensure timeliness guidelines are met.
    • Maintains check-up files to track responses from employers and NJ Dept. of Labor.
    • Abides by the terms and conditions of the Confidentiality & Non-Disclosure Agreement.

    Non-Essential Job Functions:

    • Testifies at hearings when necessary to establish the timeliness of an appeal.
    • Assumes additional responsibilities.

    Qualifications: High school graduate. Good communication skills. Individual should not pose a threat to the health or safety of self or others.


    NJHA offers a competitive salary and a comprehensive benefits package including no-deductible medical insurance, dental, flexible spending accounts, 401(k) with employer match, pension plan, (state) short term disability, long term disability, life, employee assistance program, credit union, and generous paid vacation, holiday, and personal, and sick days.


    In compliance with the ADA Amendments Act (ADAAA), should you have a disability and would like to request an accommodation in order to apply for a currently open position with NJHA, please call 609-275-4004.


    Equal Opportunity Employer/Veterans/Disabled

  • 3 Days Ago

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Claims Examiner
  • NEW JERSEY HOSPITAL ASSOCIATION GROUP
  • Princeton, NJ OTHER
  • Job Details Job Location: HBS - Princeton, NJ Salary Range: Undisclosed DescriptionThe New Jersey Hospital Association is a not-for-profit trade organization committed to delivering support and servic...
  • 7 Days Ago

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Claims Reviewer
  • VERUS CLAIMS SERVICES LLC
  • Princeton, NJ FULL_TIME
  • DescriptionVerus Claims Reviewers are responsible for first review and data capture for all types of submitted documentation related to current case management and settlement administration projects. ...
  • 9 Days Ago

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Senior Accountant
  • VERUS CLAIMS SERVICES LLC
  • Princeton, NJ FULL_TIME
  • DescriptionSUMMARYThe Senior Accountant analyzes financial information and prepares financial reports to determine or maintain record of assets, liabilities, profit and loss, tax liability or other fi...
  • 9 Days Ago

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Data Scientist
  • VERUS CLAIMS SERVICES LLC
  • Princeton, NJ FULL_TIME
  • DescriptionSUMMARYWe are seeking a diligent and detail-oriented individual to join our Analytics team as a Data Scientist. The ideal candidate will assist in project delivery, document processes and p...
  • 2 Days Ago

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Sales Manager Northeast
  • VERUS CLAIMS SERVICES LLC
  • Princeton, NJ FULL_TIME
  • DescriptionSUMMARY: The Sales Manager Northeast plays a crucial role in driving revenue and achieving sales targets for the company with a primary focus on the Northeast market of the United States. W...
  • 6 Days Ago

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0 Claims Examiner, Sr. jobs found in Trenton, NJ area

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**REMOTE** Forensic Engineer/ Architect - SoCal
  • LVI Associates
  • North Philadelphia, PA
  • Are you looking for a fully remote role with an opportunity for entrepreneurship? Join our skilled team handling diverse...
  • 3/18/2024 12:00:00 AM

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Senior Claims Specialist - Primary Casualty
  • Axis
  • Princeton, NJ
  • This is your opportunity to join AXIS Capital a trusted global provider of specialty lines insurance and reinsurance. We...
  • 3/18/2024 12:00:00 AM

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Workers Compensation Claims Examiner III _ New York
  • Tristar Insurance
  • Philadelphia, PA
  • Job Details Level Experienced Job Location Philadelphia Office - Philadelphia, PA Remote Type Fully Remote Position Type...
  • 3/17/2024 12:00:00 AM

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Claims Auditor
  • NFP
  • Woodbury, NJ
  • Who We Are NFP is a seven-time Best Places to Work award winner in Business Insurance who has also earned the 5-Star Div...
  • 3/17/2024 12:00:00 AM

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Claims- Field Claims Representative
  • Cincinnati Insurance Company, Inc.
  • Cherry Hill, NJ
  • Description: Make a difference with a career in insurance At The Cincinnati Insurance Companies, we put people first and...
  • 3/16/2024 12:00:00 AM

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Senior Assistant Data Entry Clerk
  • US Tech Solutions, Inc.
  • Bridgewater, NJ
  • Job Description: Responsibilities: On-site Presence: The Claims Screener will be required to be on-site for five days a ...
  • 3/16/2024 12:00:00 AM

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Private Investigator
  • Allied Universal
  • Perth Amboy, NJ
  • Overview: Allied Universal Compliance and Investigations, North Americas leading expert insurance claim investigations, ...
  • 3/15/2024 12:00:00 AM

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Workers' Compensation Lost Time Claim Specialist
  • Chubb
  • Whitehouse Station, NJ
  • Job Description Chubb is currently seeking a Workers' Compensation Lost Time Claim Specialist for our Northeast, New Yor...
  • 3/15/2024 12:00:00 AM

According to the United States Census Bureau, the city had a total area of 8.155 square miles (21.122 km2), including 7.648 square miles (19.809 km2) of land and 0.507 square mile (1.313 km2) of water (6.21%). Several bridges across the Delaware River – the Trenton–Morrisville Toll Bridge, Lower Trenton Bridge and Calhoun Street Bridge – connect Trenton to Morrisville, Pennsylvania, all of which are operated by the Delaware River Joint Toll Bridge Commission. Trenton is located near the exact geographic center of the state, which is 5 miles (8.0 km) located southeast of Trenton. The city is so...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner, Sr. jobs
$67,751 to $87,347
Trenton, New Jersey area prices
were up 1.5% from a year ago

Claims Examiner, Sr. in Riverside, CA
Health Claims Examiners, or Health Information Technicians, enter data electronically to process transactions.
December 14, 2019
Claims Examiner, Sr. in Evansville, IN
If you’re in dire straits, we can advise you on steps to get the OWCP claims examiner to pay attention to your needs, such as contacting the Department of Labor’s district director, or the national director via mail.
February 12, 2020
Claims Examiner, Sr. in Springfield, IL
No, the examiner is only involved in performing the exam and providing the results to the claims processor.
January 13, 2020