• Sr. Claims Examiner - SIU

    Philadelphia Insurance Companies (Ewing, NJ)


    Description

    Marketing Statement:

    Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.

     

    We are looking for a Sr. Claims Examiner - SIU to join our team!

    Summary :

    Evaluate referred insurance claims for potential insurance fraud. Conduct thorough investigations of suspect insurance claims and policy applications. Conduct insurance fraud investigations in accordance with applicable law and determine whether suspect claims meet state reporting thresholds. Work with vendor partners to conduct relevant field investigations. Complete database investigations.

     

    A typical day will include the following :

     

    Review and evaluation of claims and applications referred to the SIU for possible fraud.

     

    Conduct database investigations, including use of CLEAR, ISO and various search engines.

     

    Assignment to and coordination with third-party field investigators. Ensure third party field investigators conduct appropriate investigations.

     

    Review and evaluation of third-party investigator reports for thoroughness and accuracy.

     

    Review and evaluation of completed SIU investigations for referral to state authorities, law enforcement and/or the NICB.

     

    Work with state authorities, law enforcement and/or the NICB in prosecuting insurance fraud cases.

    EEO Statement:

    Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.

    Benefits:

    We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online.

     

    Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at https://www.phly.com/Careers/default.aspx

    REQNUMBER: 10000562