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Summary
The Claims Technical Analyst, in partnership with in-house counsel, provides technical claims guidance,
review and training related to compliance with federal and state regulations and coverage matters.
Essential Duties & Responsibilities
Reviews legislative/regulatory research and updates provided by in-house legal counsel. Ensures the
technical guidance related to legal statues, regulation and/or other requirements impacting claim
practices and processes is communicated and implemented.
Develops and implements claim handling policies and best practices. Identifies changes in claim best
practices and workflows to ensure compliance with federal and state laws and regulations. Performs
compliance audits and file reviews to ensure company is meeting regulatory requirements.
Collaborates with in-house and outside counsel to develop, maintain and update technical guidance
materials to ensure adjusters handling of claims remains in compliance with federal and state regulations.
Reviews and updates form letters and releases to ensure they are in compliance with state requirements
and are properly worded and formatted. Provides review of Disclaimers and Reservation of Rights letters
and does research on coverage matters where needed.
Develops and delivers in partnership with in-house and outside counsel, claims adjuster training and
claims training materials related to compliance and coverage matters.
Handles Medicare compliance related issues and reporting.
Serves as liaison with in-house counsel on Departments of Insurance (DOI) matters to ensure timely
reporting for compliance with governmental and regulatory agencies. Prepares information and/or
reports needed to fulfill compliance request from various DOI. Investigates compliance concerns and
determines corrective measures needed to resolve matter to the satisfaction of the DOI. May assist with
market conduct examinations.
Develops and implements Claims onboarding process for new hires. Collaborates with leaders to create new hire onboarding training schedule and identify needed resources. May conduct individual or group training sessions related to claims business systems and processes. Participates in business projects to achieve desired business objectives. Assists in coordinating and prioritizing various aspects of the project, including planning, communication, execution and completion. Performs other related duties as assigned by management.
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Summary
Processes incoming and outgoing mail using automated mailing equipment for Continental Western Group
(CWG) and other Berkley entities according to established procedures, guidelines and productivity standards.
Assembles and prepares insurance documents for mailing. Provides backup support for reception by
answering and directing calls received on a multi-line switchboard. Greets and directs on-site visitors.
Essential Duties & Responsibilities
Collects, sorts and prepares outgoing mail including agent mail, direct mail, certified mail, checks, United
Parcel Service (UPS) and FedEx shipments, and other postal packages. Uses automated mailing equipment to
prepare, process, weigh, and meter items. Reviews appearance of all outgoing mail. Maintains certified mail
records and reconciles proof of mailing on a daily basis. 50%
Opens and sorts inter-office and in-bound mail from the U.S. Postal Service, UPS, FedEx, etc. according to
destination and type. Distributes mail throughout facility according to established schedule. 15%
Assembles computer-generated insurance policies, billing statements, policyholder notices and cancellation
notices and prepares for mailing. 15%
Provides backup support to reception by answering and directing calls received on a multi-line switchboard.
Pages or transfers call to voice mail when staff is unavailable. Greets visitors, determines nature of business
and announces visitors to appropriate staff. Monitors visitor access and issues security badges when required.
10%
Maintains and updates agency and field staff name and address information in various business systems. 5%
Conducts training of new mail center staff and performs variety of support functions and backup for print
operations and scanning as needed. 5%
Performs other related duties as assigned by management.
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- Learn how our business works at all levels of the organization and customer base (internal, policyholders, agents, etc.)
- Participate in planning the user experience for all aspects of our online presence
- Take a leading role in developing our customer portal and future offerings
- Develop and implement projects (research, sketch, code, test, roll out), involving stakeholders across the organization
- Stay on top of trends and new technology - Identify future tools and strategy, and create the business case for adoption and implementation
- Work closely with the IT and Marketing teams to manage timelines, resources and communication strategy
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Personal Jewelry Underwriter for the Berkley Asset Protection digital on-line program.This underwriter will promote profitable written premium growth and favorable loss ratios in accordance with BAPU Best Practices, Underwriting Guidelines, Line of Business risk appetite, and personal Underwriting Authority as it relates to the digital on-line program.
Overall Responsibilities:
- Position involves handling both inbound and outbound customer interactions. This comes in nature of direct calls from insureds and potential insureds as well as email correspondence.
- Evaluation, rating, and pricing of appraisals for New Business risks within company guidelines.
- Executing on policy changes within authority (endorsements).
- Development of sales techniques and processes that drive revenue.
- Processes payments for policyholders including credit card (in accordance with PCI standards) and ACH payment, including payments that fail.
- Preparation of Declination correspondence to insured (when required).
- Completion/updating of data entry fields in digital on-line program.
- Completion of Rating/Review Documents as required.
- Adherence to BAPU Best Practices, Underwriting Guidelines, Line of Business risk appetite, and personal Underwriting Authority.
- Communication with and solicitation of additional information from insureds and jewelers when needed.
- Development, maintenance, and management of assigned agency/jeweler relationships through regular customer contact.
- Communication of corporate goals, programs, and underwriting policies and procedures.
- Evaluation of the performance of assigned agency/jeweler relationships to ensure company and agency/jeweler goals are met.
- Awareness and maintenance of personal production, hit ratios, renewal retention ratios, spread of risk, and other production and quality measures.
- Coordination of Loss Control services as needed.
- Act as a liaison with finance/accounting as needed.
- Management of special projects or program business as needed.
- Availability to aid in additional workflow processes when needed and subject to supervisor direction.
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We currently have a Senior Underwriter opportunity available. The main responsibilities for this position are:
- Determines risk acceptability, pricing, coverage, terms and conditions with defined limits/authority and underwriting guidelines.
- Develops positive agency relationships within assigned territory while maintaining a good rapport through responsive levels of service.
- Establish types and limits of coverage to be provided.
- Create analyze and interpret data.
- Ensures production and loss ratio goals are achieved within assigned territory by reviewing, analyzing and evaluating information and taking appropriate action as necessary.
- Develops, grows and maintains a profitable, diversified book of business through effective underwriting decision making to align with Company goals.
- Reviews new and renewal accounts to verify issuance is in compliance with Company underwriting guidelines, addressing discrepancies as needed.
- Ability to identify and problem solve for agents including finding solutions and ensuring success to the end.
- Proficient at communicating (written/verbal) information to both internal and external customers ensuring our standards of excellence
are maintained.
- Be responsible for monitoring production, profitability, and maintaining agency relationships.
- Collaborate with underwriting team and other departments, contributing knowledge and soliciting feedback relative to underwriting philosophy and company goals
- Maintain familiarity with state laws and filing requirements to properly transact business.
- Identify and recommend changes to policy verbiage when standard text is not appropriate.
- Monitor amount of insurance in force on a single risk or group of closely related risks; evaluate possibility of catastrophe losses and take action, as appropriate.
- Ability to work well with others to achieve shared goals while demonstrating diplomacy and flexibility.
- Fosters the growth and development of less experienced staff while fostering an enthusiastic environment with internal and external customers.
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This role is instrumental on portarying an engaging first impression of Nautilus Insurance. Operates Cisco multi-line telephone system to answer incoming calls and directs callers to appropriate personnel. Greets visitors and accepts packages. Performs other related duties to assist in supporting a consistent best first impression of services and facility for the end customer.
RESPONSIBILITIES
- Answers incoming telephone calls, determines purpose of callers, and forwards calls to appropriate personnel or department.
- Takes and delivers messages or transfers calls to voice mail when appropriate personnel are unavailable.
- Answers questions about organization and provides callers with address, directions, and other information.
- Welcomes on-site visitors, determines nature of business, and announces visitors to appropriate personnel.
- Retrieves messages from voice mail and forwards to appropriate personnel.
- Updates the Welcome Board daily with visitor, new hire names, anniversaries, announcements and Berkley stock price.
- Provides overhead paging for Company announcements and employee emergency calls.
- Creates night and early close greetings in PBX system.
- Updates visitor information and creates special event notices on Intranet on as needed basis.
- Participates in key roles during Fire Drill training practice with FDP Team members. Maintains readiness of materials in the event of an emergency with current occupant listing and procedures to engage.
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- 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.
- Telecommute and/or Remote Worker
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At Verus, we believe in focusing on your enthusiasm to ensure we are a dynamic and growing organization. We value the insight our adjusters bring to the organization and will give you the tools to make an impact on the future of the company. Our Claims Adjusters have a passion to resolve issues, discover win/win solutions, and keep up with the fast paced environment of Verus.
RESPONSIBILITIES
Job duties include:
- Ability to manage moderate and complex Commercial Casualty and Professional Liability claims with limited supervision. Specialty in Professional Liability is a must.
- Evaluate insurance coverage based on claim report, the insurance policy, applicable statutes and case law to determine if a claim can be accepted as within coverage.
- Able to attend mediations around the country
- Experience in completing reservation of rights and coverage disclaimer letters
- Ability to assign and supervise independent adjusters
- Willingness to handle their own inventory of claims
- Working with internal and external clients, as well as with attorneys and claimants, to resolve claims
- Willingness to process work into claims system and operate without a claims support staff
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Become a member of Acadia's Claim Department and have a direct impact on helping our customers. In this role, you'll enjoy the excitement of building relationships with agents and insureds throughout Massachusetts or New York by working with them on investigating, evaluating, reserving, negotiating and resolving casualty claims.
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What you will do:
- Deliver quality
- Develop and establish quality assurance measures and testing standards for new applications, products, and/or enhancements to existing applications throughout their development/product lifecycles.
- Conduct internal audits to measure and assure adherence to established QA standards for software development, application integration, and information system performance, and corresponding documentation.
- Perform analysis
- Prepare and deliver reports, recommendations, or alternatives that address existing and potential trouble areas in IT systems and projects across the organization.
- Analyze documentation and technical specifications of any new application under deployment or consideration to determine its intended functionality.
- Analyze formal test results in order to discover and report any defects, bugs, errors, configuration issues, and interoperability flaws.
- Relationship management
- Collaborate with software/systems personnel in application testing, such as system, unit, regression, load, and acceptance testing methods.
- Communicate test progress, test results, and other relevant information to project stakeholders and management.
- Make recommendations for improvement of applications to programmers and software developers or engineers.
- Tools and languages
- C#, .Net framework, Visual Studio, TFS, SQL Server, SSRS, SSIS, SSAS, ASP.NET MVC.
- Exposure
- Create and execute test plans and scripts that will determine optimal application performance according to specifications.
- Ensure that testing activities allow applications to meet business requirements and systems goals, fulfill end-user requirements, and identify existing or potential issues.
- Assist in the development of change control processes, practices, and guidelines for new and existing technologies.
- Participate in developing, distributing, and coordinating in-depth end-user reviews for modified and new systems or applications.
- Cultivate and disseminate knowledge of quality assurance best practices.
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The Underwriting Executive will manage existing broker and client relationships and will develop new broker and client relationships, resulting in premium generation. The Underwriting Executive will work closely with the Actuarial, Claims, and Underwriting teams to understand and achieve profitability targets. The Underwriting Executive will also 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.
Overall 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.
- Manage referrals within guidelines.
- Attend industry client centric events
- Assist with the development of new products, services, process improvements, and marketing initiatives
- Identify and report operational risks and areas in need of improvement.
- Independently make sales calls to brokers and clients, and when necessary, coordinate with Executive, Underwriting, and Claims.
- Manage ad hoc projects as required
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What you will do:
System Analysis & Design
- Maintain system protocols by writing and updating procedures.
- Handle data file receipt, processing, monitoring and logging.
- Monitor the ongoing processing of exchange partners in the production environment.
- Audit data to validate information supplied to and received from data exchange partners.
- Triage and resolve EDI issues encountered in the production environment.
- Write maps for new changes and maintain existing maps.
- Ensure compliance with data privacy and security policies.
- Recommend and implement process improvements to enhance the efficiency of the EDI processes.
Acquisition & Deployment
- Collaborate in the onboarding of new data interfaces and enhancements to existing data interfaces.
- Manage the flow of questions and feedback during the ongoing production phases of data interchange processing.
- Supply feedback on such topics as timeliness, completeness and accuracy of data receipts.
- Review the effectiveness and efficiency of existing processes and recommend strategies for improving or further leveraging them.
- Work with EDI Business Analysts, programmers, and other consultants to implement solutions.
Business Acumen
- Participate in stakeholder meetings to understand operational requirements and systems goals.
- Build and maintain positive relationships with all EDI trading partners.
- Contribute to prototyping new systems for the purpose of enhancing business processes, operations, and information process flow.
- Communicate technical procedures effectively; make data exchange concepts clear, simple, and understandable to both technical and business staff.
- Prepare exchange partner related documentation.
- Perform routine and ad hoc analysis of various facets of the ongoing EDI production environment; identify discrepancies and recommend process improvements.
- Prepare technical reports by collecting, analyzing, and summarizing information and trends.
- Support account management with EDI issues that are raised and prioritized.
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Under moderate oversight of the SVP Claims, leads various areas of the Claims department in performance of all claims handling related functions, monitoring and maintaining quality service and loss and expense goals. Responsible for the technical proficiency of the department work product to include compliance with client service instructions, BLG service standards and performance goals. Uses various metric driven tools to evaluate performance and identify problem areas to prevent and proactively address service issues. Directly and actively engages with clients to continually refine the companies understanding of client requirements and support new business initiatives and marketing efforts through service presentations to insureds, brokers and accounts in conjunction with Underwriting and Loss Control.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. These are functions that a person must be able to perform in the job, either unaided or with the assistance of a “reasonable accommodation”.
- Provide direct management to claims managers and staff to ensure a consistent work product in all areas.
- Participate in establishing, implementing, monitoring and reporting on corporate and unit goals. Establish strategic plans and provide leadership by training, developing and positioning people to attain their goals. Provide training and claim technical supervision through appropriate feedback to ensure claims are handled in accordance with BLG's performance standards and any applicable jurisdictional requirements.
- Analyze file review and service results to identify employee training and development needs and implement plans.
- Approve settlement and reserve increases for claims in excess of managers’ authority.
- Monitor loss adjustment expenses to ensure efficient utilization of staff and outside services. Monitor use of independent adjusters or attorney involvement.
- Provide SVP Claims with regular status reports on all large and potentially large losses.
- Actively seek, build and maintain excellent relationships with key broker and managing agents and policyholders. Develop and measure actions to improve customer service.
- Other duties may include: responding to insurance department complaints, account and agency visitations, handling large/complex claims.
- Retain staff by managing responsibly and creating a positive work environment.
- Keep abreast of industry developments, particularly those which impact area(s) of responsibility.
- Monitor legislative and regulatory changes related to the states within each region; attend public hearings as necessary and appropriate.
- Understand BLG's business and the factors that affect its success and growth.
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The Senior General Liability and Property Claim Specialist will:
- Evaluate and analyze coverage and be able to draft accurate and professional reservation of rights and disclaimer letters.
- Investigate and handle property, auto , and general liability claims of low to severe complexity, including claims in litigation.
- Manage outside adjusters, investigators, experts, recognize potential fraud, and handle subrogation.
- Reporting of large loss exposures to supervisors and committee large losses with management and underwriting.
- Proper and timely reserving for exposures within each claim file.
- Follow Best Practices Guidelines for handling claims.
- Provide excellent customer service.
- Maintain working diary of assigned claims.
- Strong commitment to the WRBC/Berkley FinSecure culture.
- Collaborate with other business units and co-workers to support Berkley FinSecure’s strategies, initiatives, and executive objectives.
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Berkley Life Sciences trainees participate in a variety of learning experiences to introduce them to the fundamentals of commercial property and casualty insurance. These will include a work assignment and on the job training as an Operations Specialist supporting all the various departments of the company, self- paced online learning programs, classroom instructor-led training, and a formal mentorship program. The training is progressive. Once you successfully complete the fundamentals, the content becomes more specific to the Berkley Life Sciences marketplace, products, services and company philosophy and your responsibilities will include:
- Achieving a proficiency in the technical and professional skills/knowledge of the assigned Operations Specialist position (on the job training)
- Completing all assigned departmental projects by working through the information provided and delivering the end product logically, succinctly and by the due date.
- Successfully completing all self-paced on line learning modules and class room instructor led training sessions. Report on time to all classes and complete all assignments and examinations.
- Participating in the Berkley Life Sciences mentorship program; observe experienced employees to acquire knowledge of methods, procedures and standards; strive to develop professional capabilities and potentials.
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POSITION SUMMARY: The Claims Examiner is responsible for determining and discharging the company's contractual obligations under its various policy contracts involving coverage analysis, investigation, legaldefense, and loss and expense reserving.
RESPONSIBILITIES:
- Incorporate all claims into company records and review for applicability of coverage.
- Present facts of claims, with recommendations, to committee as necessary.
- Establish initial loss and expense reserves. Maintain valid loss and expense reserves based on current investigation and legal discovery.
- Provide ongoing direction to adjusters, investigators and defense attorneys to ensure that all claims are adequately handled. Attend and participate in mediations and trials as necessary.
- Adhere to company procedures and guidelines as well as case law and statutory
- requirements when coverage is in question, and/or when paying or denying claims.
- Review trade journals, Unfair Claim Practice Acts, etc. to ensure current understanding as they relate to the specified job duties.
- Review mail for appropriate claim file on a daily basis.
- Prepare large loss reports where applicable.
- Additional tasks as assigned.
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Position Purpose:
Serves in a leadership role in the branch by providing guidance to underwriting team. Responsible for the management and growth of assigned book of business and acquisition of new business. Evaluates acceptability of individual risks and determines terms, conditions and pricing to achieve company profit objectives. Works with agents/brokers to develop productive and profitable relationships and to ensure compliance with company underwriting guidelines.
Essential Duties & Responsibilities:
- To perform this job successfully, an individual must be able to perform each of the following essential duties and responsibilities satisfactorily. Other duties may be assigned.
- Underwrites new business by reviewing the application for acceptability, requesting additional information, if necessary, and accepting or rejecting risks in conformance with company guidelines.
- Underwrites within authority set forth by Commercial Lines Vice President and within confines of company's reinsurance treaties and corresponds with agency to collect additional information.
- Underwrites renewal business by reviewing insured's file, producing agency's experience, nature and frequency of losses, loss control surveys, motor vehicle reports, and prior carrier loss experience.
- Assists Commercial Lines Vice President in development of new products, pricing, or coverage's needed.
- Develops productive and profitable relationships with agents/brokers.
Other Duties:
- Maintains an established loss ratio.
- Meets established production goals and delivers timely service.
- Serves as the staff liaison for the assigned line in disseminating line updates and developing staff.
- Travels within the assigned territory to facilitate customer development and relationship through agency visitation and prospect calls.
- Pursues a program of continuing education by participating in industry sponsored and company sponsored educational courses.
- Assists in training of other personnel as directed.
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Direct oversight and management of all workers’ compensation, automobile, property and slip + fall type general liability claims activity for Berkley Technology Underwriters.
The essential functions include, but are not limited to the following:
- Serve as Claims Account Coordinator for new customers by providing on-boarding service including: Claim kit/posting notice administration, Online reporting and systems set up
- Liaise with brokers on specific claim issues, policyholder needs, processes and protocols
- Provide broker and customer claims marketing support via agency travel, presentation, marketing mailings, etc
- Maintain quality and customer service standards – internal and external
- Provide regular reporting to BTU management on claim activity and trends.
- Review and advise on individual loss reserves
- Assure compliance with state claim requirements including Managed Care
- Management of Third Party Administrator for above noted claim types. This includes monitoring, acquisition/replacement of TPA firms as well as conducting file reviews/audits, adherence to service standards and general troubleshooting
- Management of other claim related vendor relationships
- Support organizational initiative (ie; loss run project)
May perform other functions as assigned.
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Ideal candidate will have 8-10 years or more of commercial general liability claims experience, with significant experience in complex coverage and litigated claims. Specific knowledge and expertise in New York Labor law and construction related claims are critical to this role. New York Adjuster License a plus.
Candidates must be capable of working under limited supervision and working with a remote manager. In this role, the claims professional investigates, evaluates, negotiates, and resolves litigated and non-litigated bodily injury, property damage, personal and advertising injury, and claims of high exposure and complexity.
This position is located in Manhattan, New York. Some travel would be required.
Duties and responsibilities:
- Analyze coverage, identify coverage issues, and prepare coverage letters for supervisor approval
- Focus on specialized claims in the area of construction defect
- Investigate and evaluate liability
- Investigate and evaluate damages
- Manage litigation by assigning counsel from the approved panel where applicable, establish litigation plan and budget, coordinate with defense counsel, and continuously review the potential for resolution.
- Establish timely reserves within authority and re-evaluate throughout the life of the claim
- Maintain up-to-date, appropriate file documentation and written file notes
- Maintain an active diary and productive file inventory
- Timely completion of all required large loss reporting
- Negotiate settlements within authority limit granted, and attend mediations, Mandatory Settlement Conferences, and/or Alternative Dispute Resolutions
- Proactively control the work product and expense of outside vendors
- Develop and maintain positive customer relationships and provide superior customer service
- Timely identify all potential opportunities for co-insurance, transfer of risk and/or subrogation
- Ability to Work with designated assigned accounts
- Recognize and investigate fraud
- Comply with deductible/self-insured retention recovery protocol
- Meet all State licensing requirements
- Adhere to all statutory regulations, Unfair Claims Practices acts, and corporate Best Practices
- Demonstrated success in handling cases that involve New York Labor law is critical for this role
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Position Purpose:
Evaluates acceptability of individual risks and determines terms, conditions and pricing to achieve company profit and growth objectives. Works with agents/brokers to develop productive and profitable relationships and to ensure compliance with company underwriting guidelines.
Essential Duties and Responsibilities:
To perform this job successfully, an individual must be able to perform each of the following essential duties and responsibilities satisfactorily. Other duties may be assigned.
- Underwrites new business by reviewing the application for acceptability, requesting additional information, if necessary, and accepting or rejecting risks in conformance with company guidelines.
- Underwrites within authority set forth by Commercial Lines Vice President and within confines of company's reinsurance treaties and corresponds with agency to collect additional information.
- Underwrites renewal business by reviewing insured's file, producing agency's experience, nature and frequency of losses, loss control surveys, motor vehicle reports, and prior carrier loss experience.
- Assists Commercial Lines Vice President in development of new products, pricing, or coverage's needed.
- Develops productive and profitable relationships with agents.
Other Duties:
- Maintains an established loss ratio.
- Meets established production goals and delivers timely service.
- Serves as the staff liaison for the assigned line in disseminating line updates and developing staff.
- Travels within the assigned territory to facilitate customer development and relationship through agency visitation and prospect calls.
- Pursues a program of continuing education by participating in industry sponsored and company sponsored educational courses.
- Assists in training of other personnel as directed.
Performance Expectations:
This position will be assessed based on achievement of the following elements of performance:
Attainment of goals/standards for this position; Dependability (appropriate use of time and resources, including but not limited to phone use, attendance, promptness, funds or asset use); Customer service/sensitivity (of internal and external customers); Teamwork.
Other additional elements of performance will impact this position and will be provided by the supervisor of this position.