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This position assists in the day-to-day functions of the Underwriting Audit team with the primary area of responsibility dealing with the completion of individual underwriting file audits, analysis of results and communication of findings and trends to underwriting management.
• Completes audits on new business, renewals and quotes to assess the quality of the risk and quality of the file handling from an underwriting, pricing and policy construction standpoint, as well as adherence to established underwriting procedures and authorities.
• Creates and completes “special request” audits from underwriting management on specific individuals, classes of business or programs.
• Assists in the development and updating requirements for the automated tools used to collect and track audit results and works with IT and BTS to implement and test changes.
• Initiates requests to create or update underwriting philosophies, guidelines or procedures based on audit results.
• Represents the department, as requested by the VP or Manager, in inter-departmental meetings and maintains professional relationships with internal departments, external vendors and customers.
The Senior Claims Examiner’s primary job function includes efficiently and effectively handling intermediate-level, commercial first-party property and/or third-party general liability losses in a “paperless” environment. An ability to communicate both verbally and in written form in a prompt, courteous and professional manner is essential.
• Reviews and sets up new loss assignments in a timely manner in compliance with Department guidelines and best practices.
• Establishes appropriate initial loss and expense reserves and continue to regularly evaluate the file for adequacy, accuracy and adherence to reserving guidelines.
• Analyzes and interprets policy language in conjunction with specific loss facts to reach appropriate coverage decisions.
• Drafts frequent and complex coverage correspondence, including reservation of rights and coverage disclaimers in compliance with various state statutes and regulations.
• Composes a variety of other detailed correspondence to insureds, claimants, attorneys, agents and Regulatory agencies.
• Proactively manages claim files from inception to closure, including identification and investigation of coverage, liability and damage issues, determination and efficient execution of an appropriate plan of action, and prompt, economical file resolution, in compliance with Department guidelines and best practices.
• Appropriately and clearly documents all claim file activity, including current strategy, plan of action and exit plan in file notes.
• Consistently demonstrates coverage analysis, investigation, evaluation and negotiation skills at an intermediate level.
• Directs and controls the activities and costs of numerous outside vendors including independent adjusters, defense counsel and coverage counsel.
• Effectively presents and discusses loss facts and issues in roundtable discussions to peers and members of management.
• Composes and transmits Large Loss Reports and other detailed reporting documents as appropriate in a regular and timely basis.
• Manages and monitors file caseload through the use of various resources.
• Obtains all required state adjuster licenses and maintains them as required via compliance with mandatory continuing education requirements.
• Serves as a technical resource within the Department through mentoring and knowledge-sharing, whether one-on-one, in small groups, or presentations to larger groups.
• Meets with intern personnel and others as needed to provide job function overview and/or specific subject-matter training.
• Occasionally participates in projects and initiatives lead by other departments and/or W. R. Berkley companies, including audits, workshops, focus groups, task forces, etc.
• Initiates appropriate communication with members of management and other Departments.
• Attends internal and external seminars and other training events and provides feedback to peers and/or members of management.
• Other duties may be assigned.
Responsible for planning, directing and overseeing the Underwriting Audit department, including managing and supervising the Underwriting Audit Coordinators. Sets and achieves department goals to support the company’s key strategic objectives. Oversees the completion of individual files audits, conducts quality control on completed audits, analysis of results and trends, scheduling and provides communication of findings to underwriting management. Develops new audits based on company goals and provides agency consulting services as needed.
- Manages the work and production of the Audit Coordinators.
- Provides oversight of the completion of audits on new business, renewals and quotes to assess the quality of the risk and quality of the file handling from an underwriting, pricing and policy construction standpoints, as well as adherence to established underwriting procedures and authorities.
- Works with Coordinators to provide feedback to Underwriting Management (based upon review findings) to identify strengths in Underwriting talents and to identify opportunities to improve various underwriting criteria and/or requirements as relates to Company underwriting standards.
- Develops new underwriting audits to reflect changes in underwriting philosophies and strategies.
- Shares high-level trends with management.
- Creates, analyzes and interprets data from various reports.
- Works as direct contact with Regulatory for SOX compliance testing.