Executive Claims Specialist, PIP, Remote

Crum & Forster Company Overview

Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.

Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.

C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website: www.cfins.com.
Job Description

S&S Transportation & Sharing Economy is seeking an experienced Executive Claims Specialist – Personal Injury Protection / No-Fault to provide senior-level technical oversight of Personal Injury Protection (PIP) claims within our sharing economy program. This position will primarily support multiple states with New Jersey , New York and Pennsylvania no-fault experience strongly preferred. The ideal candidate is a seasoned PIP professional with strong technical judgment, litigation and arbitration experience, and the ability to partner effectively with Third-Party Administrators and other stakeholders to promote quality claim outcomes. This is an oversight and technical leadership role rather than a traditional claim-production position .
What you will do for C&F:

- 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 compliance with applicable statutory and regulatory requirements.

- Partner with TPA claim professionals and leadership to address claim handling concerns, reinforce program expectations and identify opportunities for improvement.

- 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 internal and external partners as appropriate.

- Support enhancements to claim guidelines, workflows, reporting, training and quality controls.

- Maintain awareness of legislative, regulatory and judicial developments affecting PIP/no-fault claims.

What you will bring to C&F:

-
6+ years (8-10 preferred) of progressively responsible PIP/no-fault claims experience , including complex or technically advanced matters.

- 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