Executive Claims Specialist, PIP

Crum & Forster

. Provide senior-level technical oversight of PIP/no-fault claims administered by Third-Party Administrators .

Posted 9/15/2026full-timeRemote • New Jersey • United StatesMid-LevelSenior💰 $64,700 - $121,600 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive expertise in PIP/no-fault claims management, including regulatory compliance, medical management, and litigation oversight. Proven ability to evaluate claims, conduct audits, and provide technical guidance to improve claim handling processes.

Highest-signal resume keywords

PIP Claims ManagementRegulatory ComplianceLitigation ExperienceTPA OversightMedical Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims EvaluationCoverage AnalysisBenefit Eligibility AssessmentQuality AssuranceRisk-Transfer EvaluationClaim AuditsStatutory Compliance ReviewDisputed Claims ResolutionReserve Adequacy EvaluationTrend Analysis

Soft Skills

Analytical SkillsWritten CommunicationVerbal Communication

Certifications & Qualifications

CPCUAICSCLALaw Degree

Industry Keywords

PIP ClaimsNo-Fault ClaimsThird-Party AdministratorsCommercial AutoRideshareTransportation Network CompanyEmerging ExposuresMedical NecessitiesPeer ReviewsDenials

About the role

Key responsibilities & impact

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 statutory and regulatory compliance
Partner with TPA claim professionals and leadership to address concerns and improve claim handling
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 partners
Support enhancements to claim guidelines, workflows, reporting, training and quality controls
Maintain awareness of legislative, regulatory and judicial developments affecting PIP/no-fault claims

Requirements

What you’ll need

6+ years of progressively responsible PIP/no-fault claims experience; 8–10 preferred
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

Benefits

Comp & perks

Competitive compensation package
Generous 401K employer match
Employee Stock Purchase plan with employer matching
Generous Paid Time Off
Health, dental and vision benefits
Wellness programs focused on physical, mental and financial wellbeing
Tuition reimbursement
Industry-related certifications
Professional training
Dynamic, ambitious, fun and exciting work environment
Matching donation program
Volunteer opportunities
Employee-driven corporate giving program
Special accommodations and inclusive workplace support