Claims Examiner (E&O)

Summary:

Under the dual supervision of the Claims Manager and the Sr. Policy Analyst/Complex Claims Examiner, a Claims Examiner (errors and omissions) investigates, evaluates, and manages claims brought against NJSIG members that are covered by NJSIG’s School Leaders Errors and Omissions policy. This position is responsible for administering and resolving claims alleging discrimination or wrongdoing under a variety of federal and state statutes, including claims for wrongful termination, negligent hiring, negligent retention and negligent supervision, as well as related administrative actions.

Functions:

a. Administers NJSIG member claims under the School Leaders Errors and Omissions Policy, including claims brought under: 42 U.S.C. § 1983, Title VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act of 1967, Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Page 2 of 5 Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, the Individuals with Disabilities Education Act of 1990, the New Jersey Civil Rights Act, the New Jersey Law Against Discrimination, the New Jersey Conscientious Employee Protection Act, etc.

b. Initiates contact with individuals involved in claims and acquires information concerning the loss.

c. Conducts detailed investigations into claims, analyzes evidence, and collaborates with internal and assigned legal counsel and adjusting professionals to assess liability and develop effective claim resolution strategies.

d. Communicates with NJSIG members on all coverage issues, including by writing detailed, complex coverage reservations and disclaimers, as appropriate.

e. Manages and administers School Leaders Errors and Omissions claims and requires a thorough understanding of the nuanced and complex nature of employment practices litigation.

f. Assembles, prepares, and maintains comprehensive and accurate documentation of School Leaders Errors and Omissions claims, including relevant records, details, correspondence, and actions taken, clearly memorializing the claims handling process.

g. Reviews expense and legal bills for appropriateness and approves for payment.

h. Identifies potential subrogation recovery opportunities and refers any recovery action to the Senior Claims Representative (subrogation).

i. Evaluates exposure and determines the action necessary to resolve claim within authority level, where possible.

j. Assembles and arranges factual information in a manner adequate to justify the recommended claim resolution strategy, subject to management authority.

k. Utilizes effective negotiation techniques to achieve favorable settlements while advancing the interests of NJSIG members and maintaining a commitment to excellence in claims handling and member service.

l. Stays abreast of evolving laws, regulations, and industry standards related to School Leaders Errors and Omissions claims to ensure accurate and compliant claims handling.

m. Works closely with internal teams, including the Liability team, to ensure a cohesive and coordinated approach in handling claims.

n. Contributes to the development and implementation of risk management strategies for NJSIG members to prevent future School Leaders Errors and Omissions claims. 

o. Maintains a member-focused disposition to ensure that NJSIG members are regularly updated on the status of claims and that excellent customer service is provided.

p. Monitors inquiries made to, and responses provided by, the NJSIG Employment Practice Hotline Attorney (NEPHA).

q. Participates in special projects and presentations on errors and omissions trends, as required.

Qualifications:

a. Bachelor’s degree in Business Administration, Finance, or Accounting, or equivalent work experience is required.

b. Minimum of seven years’ experience in adjusting errors and omissions claims in the State of New Jersey is required (experience adjusting claims for an intergovernmental risk pool is preferred).

c. Associate in Risk Management, Certified Risk Manager, or Associate in General Insurance designations preferred.

d. Ability to work in an office environment with moderate noise level, to work flexible hours (including evenings and weekends), and to travel to other offices and work sites as required.

e. Residency in the State of New Jersey in accordance with the New Jersey First Act, N.J.S.A. 52:14-7, et seq., unless otherwise exempted.