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Claim Specialist

CESNA GROUP INC - Englewood Cliffs, NJ

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Job Description

Job Summary Job Type: Full Time (3 months' probation period applies) Position(s): Claim Work Schedule: In-Office Salary: Based on Experience Job Description Review homeowners insurance claims to determine coverage eligibility based on policy language, claim facts, and applicable laws. - Review and validate claim payments and loss reserves recommended by Third-Party Administrators (TPAs). - Ensure timely and accurate claim payments and manage claim expenses in coordination with TPAs. - Provide guidance to field adjusters on claim investigation, scope, and resolution when needed. - Select and manage defense counsel on litigated claims. - Identify potential insurance fraud and initiate appropriate handling procedures. - Analyze claim data and trends, including use of geographic or hazard-based tools. - Utilize analytical tools (e.g., R, Python) to support claim trend analysis where applicable. - Perform other duties as assigned. Qualifications - Bilingual in Korean and English (written and spoken). - Bachelor's degree or higher. - Proficient in Microsoft Excel, PowerPoint, and Word. - For experienced candidates, a minimum of 2 years of experience in the insurance industry (including (re)insurance carriers, claim TPAs, or underwriting agencies) is preferred. - Strong attention to detail with the ability to manage multiple claims and priorities. What's On Offer Benefits: Insurance (Health/Dental/Vision), Paid Leave (PTO/Sick), Apply online or feel free to contact us directly for more information about the opportunity. Due to the high volume of applicant, we regret to inform that only shortlisted candidates will be notified. Thank you for your understanding.

Created: 2026-03-10

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