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Carolina Casualty is looking for a talented professional who will be responsible for providing support to claims department adjusters and management.
Principle Responsibilities
- Assist the Claims Leadership Team with claims compliance issues such as adjuster licensing, fraud training, claims related regulatory changes, claims handling complaints, research and others
- Assist the Claims Leadership Team and claim adjusters with special projects
- Assist the Claims Leadership Team with vendor management including, but not limited to, W9 management, reporting, performance management, recruiting, communication
- Coordinate new client welcome calls, renewal activities and claim reviews
- Support the claim department self-audit process
- Assist adjusters with SIU referrals
- Process new claims including initial claim customer contact, set up new claims, gather information from policy systems, enter claim information into claim systems
- Draft acknowledgement letter
- Process claim payments
- Draft underwriting advisories
- Maintain, develop, coordinate department reports
- Provide first level contact for external customer service inquiries
- Follow up with business partners via phone/email regarding claims inquiries
- Coordinate Medicare matters, including completion of claim data to ensure accuracy of Medicare queries
- Review monthly log containing response files from CMS and correct errors.
- Partner with the bodily injury adjusters to ensure compliant resolution of all claims involving a Medicare Beneficiary including obtaining the Medicare Conditional Letter
- Coordinate the issuance of Medicare regulatory and/or compliance letters
- Perform other duties and/or projects as assigned
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JOB DUTIES
Claims – Third Party Administrator Duties
- Updates claim notes and claim financial data, as needed.
- Scans and attaches documents to claims files.
- Administers claims reimbursement process.
Claims Identification
- Reviews paper mail and emails to identify catastrophic claims within 24 hours of notification by client.
- Immediately notifies the Catastrophic Claim Team of severe claims verbally and in writing.
General Claims Duties
- Assists with technical problems, such as password & data issues or Excel problems.
- Reviews and processes the paper mail that comes to the claims department.
- Orders lunches and handles external event planning, as needed.
- Assists in improving and maintaining department best practices.
- Works with manager and analysts to complete department reports’ KPIs (key performance indicators).
- All other duties as assigned
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The Associate Underwriter will work closely with the Underwriting team to analyze risk, exposure, loss and coverage information for group and individual risk accounts, and structure and price programs that are financially efficient for the insured and profitable for the company. The Associate Underwriter will also work closely with the Underwriting team to manage existing broker and client relationships.
- Review new and renewal submissions for completeness and address any discrepancies with the broker.
- Organize and aggregate loss and exposure information and input into pricing models.
- Analyze and interpret risk data and enter exposure and loss data into pricing models.
- Work with actuarial to understand the key components of the pricing models.
- Maintain broker relationships though superior levels of service and direct broker engagement.
- Attend industry client centric events as required
- With the Senior Underwriting team, make sales calls to brokers and clients, and when necessary, coordinate with Executive, Underwriting, and Claims.
- Assist with the issuance of policies, endorsements and billing.
- Process reinsurance and account transactions
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Berkley Agribusiness, a provider of property and casualty insurance solutions for select commercial agribusiness accounts, has an exciting employment opportunity for a Risk Control Specialist to service agribusiness and food product customers.
Located in the Western (California) Region, this position will be responsible for providing on –site risk control surveys for both prospective and existing policyholder locations for the purposes of gathering underwriting information and providing suggestions for risk improvement.
Specific duties include, but not limited to:
- Surveying commercial agribusiness properties (buildings, industrial operations, etc.)
- Consulting with insured's in regards to activities and programs available to control losses and improve safety
- Providing training, mentoring, specialized technical advice and counsel to internal staff regarding regulations
- Contributing to the development of safety materials and program.
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Within authority, the incumbent will manage assigned brokers to underwrite and process environmental and/or casualty lines for the Environmental Services Industry and/or Environmental lines for any industry segment.
Duties and Responsibilities:
- Work with assigned brokers to underwrite General Liability,Pollution, Professional Liability, Automobile, Worker Compensation and Excess lines focused on the Environmental industry.
- Visit existing and potential new brokers to discuss our products and procedures such as; underwriting appetite, premium collection policy, profitability issues, pricing and coverage issues.
- Possess the capability to handle all lines of business and all types of rating programs
- Capable of looking beyond individual account transactions; managing a book of business to achieve new business, renewal retention and ROE objectives in support of the Division.
- Handle all aspects of processing the Broker accounts.
- Perform financial analysis on the audited/reviewed financials or other financial information of insures using appropriate tools.
- Create and solicit renewal applications from the broker after reviewing the expiring policy and loss information.
- Underwrite endorsement requests from brokers and sign-off where required.
- May assist other underwriters in processing renewals, new business and endorsements.
- Serve as a top underwriting resource.
- Provide professional development knowledge and insight to less experienced staff members.
- May help train new underwriters and provide coaching.
- As needed, assist the Assistant Vice President or other Senior Managers in any assigned marketing, administrative or technical training issues.
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The Vice President, Claims is responsible for the overall management and direction of the claims department. Equally as important, participation on the Executive Team, that establishes the strategic direction for the company and ensures the overall profitability and success of the company in the human services market.
RESPONSIBILITIES:
Member of Executive Team
- Proactive participation on Executive Team which establishes and executes the strategic direction of the company
- Work closely with the CEO to discuss, evaluate, and implement strategic directions for the claims operation that supports the overall direction of the company
- Establish solid relationships with other members of the Executive Team in order to improve team performance
- Be able to clearly communicate strategic direction to both internal resources and outside partners and insureds
Overall Management of Claims Operation
- Manage a team of claims professionals by establishing clear performance metrics
- Implement strong policies and procedures designed to produce the desired results
- Ensure the continual professional development of claims professionals on the team by coordinating both internal and external training and development opportunities
- Develop and implement claim best practices for proper and consistent claim performance, compliance and achievement of business goals
- Establish clear reserving standards and ensure that those standards are continually met
- Identify issues and trends in the portfolio; take appropriate and/or corrective action where necessary; communicate trends to underwriters, insureds and brokers
- Identify claims with significant exposure and take a more active role coordinating a strategy for an appropriate resolution
- Coordinate with underwriting on current and proposed policy language and new markets to enter
- Cultivate a departmental culture that excels in communication and collaboration
- Drives the development, implementation and continuous planning, organizing and leading of all claim programs, metrics, processes, results and initiatives
Develop Berkley Human Services into a “Thought Leader” within the human services marketplace
- Proactively establish relationships with brokers and insureds in order to maximize the competitive advantage derived from the claims operation.
- Develop and manage the reputation of BHS’s claims handling in the market
- Attend industry conventions and events and become a sought out thought leader on developing issues
- Attend marketing, account renewal, and reinsurance meetings as appropriate in order to communicate our claims handling philosophy and leading position in this area
- Instill the above philosophies into all claims professionals at the company
- Work closely with company’s loss control function to provide value-added services to our insureds that reduce our exposure to loss
Liaison to both internal and external partners of the company
- Liaison with parent company, WR Berkley, on significant individual claims and trends identified in the overall portfolio
- Communicate portfolio trends and potential solutions to underwriting and actuarial areas
- Participate on quarterly performance calls with parent company in anticipation of earnings releases
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The QA Lead establishes metrics, mentors team members and manages outside resources, as well as developing test programs. This role will help develop and establish quality assurance consistencies, standards and measures for the Quality Assurance department within the IT organization. As a Lead/Automation Software Quality Assurance Engineer, they will be responsible for ensuring quality throughout the SDLC and performing systematic software testing across all product lines. The candidate will lead quality efforts around defining test approach and writing/executing test cases for all applicable test levels. They will be responsible for reporting and tracking defects to resolution. The chosen candidate will be involved in the full SDLC from requirement reviews through release and post live validation, and will document all required quality artifacts.
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Verus has an opportunity for a Senior Underwriter to join the team! Under minimal supervision, this position will be responsible for underwriting individual Garage risks and managing a book of business to achieve company premium and profit goals. This role will work within designated underwriting authority and guidelines, rating rules and insurance laws and regulations, as well as company policies and practices. The Senior Underwriter will maintain and develop broker relationships, including addressing opportunities and/or areas of concern. Assists with training and development of underwriting staff. It will participate in product line management including product enhancements as well as corrective actions. This opportunity involves business travel.
Responsibilities will include but are not limited to:
- Effectively underwrite larger and more complex risks within assigned product line
- Select individual risks with company product line pricing and underwriting guidelines
- Utilize and apply ISO and Verus coverage forms and endorsements based on individual risk and class of business criteria
- Make appropriate recommendations for modifications to Verus coverage forms and endorsements through providing supporting analysis and thought processes that are documented appropriately
- Work effectively and within an assigned level of underwriting authority with roughly 10-15% of accounts requiring referral to a higher level of authority
- Refer accounts outside of assigned underwriting authority with complete information and including a recommended course of action with supporting analysis
- Consistently meet or exceed designated LOB production metrics
- Effectively establish positive and productive working relationships with assigned brokers through travel/visitation and by engaging remotely
- Clearly and concisely communicate underwriting appetite for a particular product line both verbally and in writing
- Identify and make recommendations for addressing broker performance issues with supporting analysis
- Provide consistent documentation of underwriting files to Verus and industry best practice standards
- Make appropriate recommendations for modifications to product line underwriting and pricing guidelines with supporting analysis
- Respond to underwriting referrals from underwriters with lesser authority as assigned by product lead
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Verus has an opportunity for an Underwriter to join our team. Under broad supervision, this position will be responsible for underwriting individual Garage risks and managing a book of business to achieve company premium and profit goals. The role will work within designated underwriting authority and guidelines, rating rules and insurance laws and regulations, as well as company policies and practices. Maintains and develops broker relationships. This opportunity involves business travel.
Responsibilities will include but are not limited to:
- Selecting individual risks with company product line pricing and underwriting guidelines
- Utilize ISO and Verus coverage forms and endorsements based on individual risk and class of business criteria
- Work effectively and within an assigned level of underwriting authority with roughly 2/3 of accounts requiring referral to a higher level of authority
- Refer accounts outside of assigned underwriting authority with complete information and including a recommended course of action
- Consistently meet or exceed designated LOB production metrics
- Effectively establish positive and productive working relationships with assigned brokers
- Clearly and concisely communicate underwriting appetite for a particular product line
- Identify and call appropriate attention to broker performance issues
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Will be assigned Commercial Auto claims and will perform all claim duties associated with the investigation, evaluation and resolution of all claims assigned.
The essential functions include, but are not limited to the following:
- Understands and can apply coverage for the claims assigned. Issues appropriate RORs and disclaimers.
- Conducts the necessary investigation, either by phone, or through independent adjusters, to determine coverage, liability and damages.
- Evaluates, negotiates, and settles assigned claims within authority granted, or seeks authority for those claims in excess of authority.
- Identifies subrogation/contribution/deductible recovery opportunities and effectively pursues recovery when appropriate.
- Assigns and actively directs independent adjusters as well as defense attorneys. Complies with litigation management guidelines.
- Keeps claim files maintained in a consistent and organized manner, diaries are kept current, and reserves are constantly assessed for adequacy throughout the life of the claim.
- Complies with reinsurance and client reporting guidelines.
- Issues loss and expense payments properly and on a timely basis.
- May perform other functions as assigned.
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Summary
The Claims Client Services Manager will help maintain business relationships with current clients and assist in the on-boarding process of new clients. The Client Services Manager will help our clients to better understand the full potential of our services and products and act as liaison between the client and the Berkley Agribusiness Claims team.
Essential Duties & Responsibilities
- Onboarding new clients by establishing themselves as point of contact and meeting with client to understand their business as well as claims service needs. Ability to set up system portal for access to claims information, discuss claims structure and address questions and concerns. Create client specific claims handling instructions for use by team in servicing accounts, seek agreement of claims, implement and follow up with customer in a proactive manner. For Loss Sensitive/Alternative Risk accounts, evaluate claims history to determine size and spend of client claims loss fund
- Build and solidify relationships with key clients and brokers by serving as a single point of contact for claim service needs. Effectively communicate Berkley Agribusiness Claims value proposition by coordinating with Underwriting and Business Development in support of acquisition of new business. Communicate claim handling philosophy/guidelines/services with brokers and agents by engaging customers and brokers to seek feedback on service offerings and satisfaction level. Evaluating and escalating claims level issues to the proper Claims leader as appropriate
- Participate and/or coordinate client stewardship by planning, coordinating, facilitating and conducting client claim reviews in a proactive manner in accordance with agreed service standard and client handling instructions. Evaluate and update existing claims special handling agreements, seek agreement of claims, implement and follow up with customer in a proactive manner. For Loss Sensitive/Alternative Risk accounts evaluate internal historical spend to determine adequacy of individual client claims loss fund.
- Research industry trends and service standards to ensure Berkley Agribusiness claims service offerings are in a market setting position. Collaborate with claims team to recommend service improvements and product offerings. Create and maintain claims data reporting and industry benchmarking tools for client and broker use.
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Key Accountabilities:
- Demonstrates a robust understanding of all the business data processes/processing, system interfaces, and where/how that data is used, and the related data structures.
- Design and implementation of ETL process, data structure and the analytical/operational reporting environment. Can design significant new system functionality with a consideration of performance, stability, and supportability
- Thorough understanding of industry best practices. Includes but not limited to modeling, workflow and presentation. Design and implement data extracts both inbound and outbound for internal and external sources.
- Demonstrates problem solving skills that span the application, middleware, and infrastructure levels. Thorough upstream/downstream impact analysis. Assists in defining standards and design patterns/paradigms for data processes and/or structures for development within a team.
- Can produce significant new system functionality or defect resolution with minimal direction
- Creates design specifications that demonstrate an understanding of most interfacing systems and supported business processes. (can understanding business processes go to the developer/analyst)
- Routinely proposes improvements to a data process and/or structure to improve supportability or usability.
- Can perform adequate peer review on any changes in the system
- Can be consulted to provide recommendations to solve business issues and knowledge of current technology
- Demonstrates understanding of data processes and/or structures
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The Underwriter will work closely with the Senior Underwriting team, and Chief Actuary, to analyze risk, exposure, loss and coverage information for group and individual risk accounts, to structure and price programs that are financially efficient for the insured and profitable for the company, and will Identify and utilize data-driven analyses to drive marketing efforts relative to customer acquisition and retention. The Underwriter will also work closely with the Senior Underwriting team to manage existing broker and client relationships.
RESPONSIBILITIES:
- Review new and renewal submissions for completeness and address any discrepancies with the broker.
- Organize and aggregate loss and exposure information and input into pricing models.
- Analyze and interpret risk data and complete an underwriting workbook for each eligible risk.
- Work with actuarial to understand the key components of the pricing models.
- Establish and maintain broker relationships though superior levels of service and direct broker engagement.
- Attend industry client centric events
- Assist with the development of new products, services, process improvements, and marketing initiatives
- Attend marketing calls to brokers and clients, and when necessary, coordinate with Executive, Underwriting, and Claims.
- Under direction of Management, work on ad hoc projects as needed.
- Assist with the issuance of policies, endorsements and billing.
- Process reinsurance transactions, where applicable.
- When necessary, complete account transactions as required
- Process new business/renewals and endorsements for assigned accounts and perform underwriting analysis for some routine new and renewal busines
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Independently contributes to growth and profitability serving as an underwriting subject matter expert and advisor to underwriters at all levels of learning and experience. Has highest level of underwriting authority. Works closely and mentors/coaches underwriters with their reviews and evaluations of complex new and renewal business, as needed, in accordance with established underwriting guidelines and assigned authority levels. Exhibits advanced knowledge of how to manage agents effectively. Presents, supports, and markets Company products, technology and services both internally and externally. Identifies and recommends training needs for underwriters. Provides appropriate feedback to Management regarding growth and development of underwriters. Inspires and energizes others by providing leadership guidance.
RISK SELECTION
- Responsible for determining risk acceptability, pricing, coverage, terms and conditions with defined limits/authority and underwriting guidelines.
- Provides Assistance in underwriting of difficult complex accounts, including approving referrals that exceed the authority of others.
- Assists with quoting new and renewal business in order for Region to maintain their service standards (as needed).
- Supports the region by serving as a “floating underwriter” (to cover underwriters out on travel, PTO, etc.) as well as maintain service standards in this role.
AGENCY MANAGEMENT
- Demonstrates complex decision making with minimal to no supervision, recommending exceptions where appropriate to maximize profitability and meet business goals.
- Actively participates conducting internal audits on underwriting staff and coordinates review of Book Management Assessments (BMAs) on our agent’s books of business.
COMMUNICATION & TIME MANAGEMENT
- Proficient at communicating (written/verbal) information to both internal and external customers ensuring our standards of excellence are maintained.
- Ability to work well with others to achieve shared goals while demonstrating diplomacy and flexibility.
LEADERSHIP
- Mentors, coaches and serves as a technical subject matter expert or resource to other underwriters on an ongoing basis.
- Actively engaged in participating in underwriting huddles, region meetings and claims round tables.
ADDITIONAL DUTIES AND RESPONSIBILITIES
- Ability to perform all Senior Underwriter duties as needed.
- Proficient at recommending changes to policy verbiage when standard text is not appropriate via manuscript endorsement.
- Participate or leads in the research of new agency programs, underwriting procedures and special projects/committees.
- Attends classes internally and externally to help build upon existing expertise and stay on top of emerging issues and/or industry trends.
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The Chief Underwriting Officer’s role is to provide the leadership and functional expertise needed to preserve and enhance profitability through the development of underwriting and analytic techniques, effective management of pricing methods, and the analysis of competitive landscape.
The Chief Underwriting Officer will support the Product Line Leaders by developing the underwriting protocols and processes that will enable those with responsibility for the day-to-day underwriting to achieve their business plans.
Key duties include:
- Responsible for the development, implementation and management of long and short term underwriting strategies and the management of the underwriting process. In this capacity, ensures that underwriting results and service support the profitability, growth and retention of the Casualty, Professional and Garage lines of business and are consistent with overall business objectives.
- Maintain product line specific underwriting policies, guidelines and procedures and make changes where appropriate. Prepare, coordinate and execute product line specific training for underwriters and support staff.
- Responsible for assessing the quality of underwriting and the development of action plans that will enhance underwriting knowledge and expertise.
- Participates in and oversees periodic underwriting audits to be certain philosophies and procedures are being followed.
- In response to underwriting audits, develop recommendations and action plans in conjunction with Product Line Leaders. Ensure that each office reviewed understands their opportunities for development and that actions going forward are consistent with Verus’ underwriting and regulatory compliance standards. Conduct follow up reviews to verify implementation of the action plans agreed upon.
- Interact with various underwriting staff on their respective books of business, including acting as a referral resource. Maintain a collaborative underwriting approach regarding underwriting selection and pricing decisions outside Field Authority. Also available for advice on accounts within Field Authority when so desired.
- Participation in strategic business planning activities that are designed to increase the presence in the market, retain the appropriate mix of business, and achieve overall growth and profit goals.
- Develop and maintain relationships with internal resources (i.e., Actuarial, Marketing/Business Development, Claims, Operations, etc.) to facilitate the operational effectiveness of underwriting and marketing decisions.
- Functions as product development liaison, which includes the development and/or enhancement of new and/or existing products and market entries. Makes certain that products are competitive from a pricing and coverage standpoint and work to assure that products are in compliance with all insurance laws, regulations and Company strategic plans.
In collaboration with the Corporate Underwriting and Product Line Leaders, manage all treaty reinsurance presentations and renewal processes. Monitor, review and document reinsurance arrangements and communicate to the field any necessary underwriting adjustments as a result of reinsurance negotiations.
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Duties and Responsibilities:
- Monthly billing and collection processes – policy premiums and deductibles.
- Mailing monthly statements.
- Investigating and correcting statements.
- Maintaining records of accounts.
- Responsible for timely system application of cash receipts and reconciliations of current outstanding & monthly amounts recovered.
- Corresponding with underwriters, agents, insureds, premium finance companies, collection agency and attorneys.
- Generating past due and cancellation notices.
- Assisting in month end close.
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Great opportunity to gain practical marketing experience in a business environment!
Acadia Insurance is seeking to expand its digital marketing presence through the creative use of video media! Video projects will be focused in several key areas: educational agency/customer content, brand content, and recruitment content. Other digital marketing projects that this person will be involved in will include: enhancing the search engine optimization of Acadia’s public website, assisting in the production and distribution of podcast content, as well as other miscellaneous marketing projects.
If you are a self-driven, motivated and curious individual who enjoys working with others and who has an interest in video marketing, then this internship is for you! Personal or professional experience or equivalent education in digital marketing and video production is preferred.
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The Claims Counsel is responsible for assisting with the efficient management of the Admiral Claims Department, including managing the various vendors and resources Admiral utilizes in adjusting claims as well as assisting with litigation management, overseeing the review and payment of our litigation partners, assisting with and analyzing metrics, rendering legal advice to members of the Claims Department and carrying a limited caseload of unique claims when necessary.
RESPONSIBILITIES:
- Manage panel counsel including retaining new counsel and updating counsel guidelines periodically.
- Provide direction in improving litigation management. Review legal decisions and develop a database on relevant topics and case law.
- Attend and facilitate Claims Committee as requested. Review policy construction and offer coverage advice where appropriate.
- Oversee the legal and I/A bill review process.
- Assist with analytics and metric development and interpretation.
- Resolve claims according to Best Practices and within authority limits and potentially adjust claims for certain accounts or types of litigation.
- Coordinate responses to subpoenas requesting documents or information.
- Review Waivers, Releases and Non-Disclosures and provide counsel as appropriate.