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To produce profitable growth of the Berkley Human Services book of business and represent Company in all sales and service activities for assigned accounts or regions.
ESSENTIAL RESPONSIBILITIES/FUNCTIONS:
The essential functions include, but are not limited to the following:
- Agency visitation (travel in-state and out-of-state required) for marketing purposes.
- Solicit/develop new business opportunities.
- Agency management responsibilities.
- Provide guidance/coaching to underwriting staff in the area of agency management and marketing in general.
- Assist in the development of promotional materials.
- Analyze new business/market trends and communicate the results to underwriting and management staff.
- Represent company at various association and trade shows as requested.
May perform other functions as assigned.
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The Special Risk Division of Berkley Accident and Health offers customizable accident insurance solutions that may help groups, individuals and families minimize the financial impact that can result from a covered accident. We are seeking a Products & Compliance Analyst to join our team. Duties and responsibilities include but are not limited to:
- Assist with Product Development of a vast array of group, blanket and individual accident products, supplemental health products, specified disease products and other Accident & Health products
- Prepare and submit form and rate filings via SERFF and I-File after thorough compliance review of relevant legislation and regulatory updates
- Work collaboratively with Underwriting and Actuarial, as applicable, to promptly address Insurance Department inquiries, negotiate regulatory approval in the required jurisdictions and prepare detailed instructions for products’ use upon approval
- Develop and maintain successful and productive relationships with state insurance department personnel to effectively resolve filing issues while furthering company interests
- Manage filing status for all products and update all applicable status charts and other internal documents
- Maintain a database of product filings including the due dates and status of the filings, prepare reports on the status of filing projects for management and maintain form, rate and rule manuals for implementation
- Prepare thorough and clear communication to IT Department regarding any changes to currently automated forms and/or additions to automated system necessitated by each new approval. Must provide proper print rules, work with programmers, testing of output and sign-off prior to release to the business unit
- Assist with efforts to automate all Accident & Health policy forms including reviewing and commenting on policy specifications, inventory of approved state-specific text and rules, clarification of issue instructions, creation of test cases, participation in policy fulfillment testing, creation and maintenance of tracking logs, quality assurance, and other related tasks
- Perform compliance research and other projects as requested
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- Participate in all aspects of the underwriting process, including analysis, evaluation and determination of the degree of risk associated with assigned book of accounts.
- With minimal supervision, underwrite a $15M book of highly complex and diverse energy risks, with a special focus on energy sustainability related risks.
- Using territorial and technical knowledge of oil and gas industry, perform risk assessment, pricing and profitability, and exposure analysis of the energy accounts.
- In underwriting accounts, perform analysis of related energy policy and energy economic issues.
- Develop multiple large agency relationships, including growth and profitability goals of those agencies.
- Apply knowledge of a variety of complex pricing, rating and risk analysis tools and methodologies.
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Berkley One, a Berkley company, is hiring a Berkley One Support Service Specialist in our Wilmington, DE office. This role’s primary objective is to deliver all that is great about Berkley One and to help our agents place and maintain business with us. Duties and responsibilities include but are not limited to:
- Client Policy Support: Complete follow up tasks for active policies, while supporting the underwriting and service initiatives within the organization. Help complete foundational policy changes and endorsements, requested by agents, clients, and/or business partners, while maintaining quality and efficiency.
- Agency Support: Develop formal proposals for account and policy quotes generated for an agency. Help support new agency onboarding by enrolling new agents/staff into our system. Create and send agency contracts via e-signature. Assist in facilitating website quote requests and routing to appropriate avenues.
- Clerical Mailing and Print Support: On demand mail and electronic correspondence creation based on client or agency needs. Support of mailing and printing of output generated to clients and agencies. Scanning and indexing of documents received. Reviewing, processing, and storage of returned mail.
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The Clinical Services Manager provides leadership and direction to the Clinical Services team including Telephonic Case Managers, Clinical Triage Specialists, and other products specialists as deemed strategically appropriate as the business continues to evolve. S/he also provides input into the activities and priorities of the work support provided by the team of Clinical Care Specialists. Is accountable for process oversight, achievement of Team Quality and Productivity Standards, meeting or exceeding department metrics, modeling outstanding customer service behaviors and serving as the voice of authority during file reviews both internally with Berkley Medical Management Solutions (BMMS) and externally with the Berkley Sister Companies and their Clients. Duties and responsibilities include but are not limited to:
- Attract, lead, manage, coach and mentor team of experienced professionals to ensure retention, development, and superior performance against KPI’s and client expectations.
- Collaborate with other Leaders to perform tasks including diagnosis, design, intervention, remedies, and implementation of solutions to enhance organizational effectiveness as well as employee development, productivity, engagement and retention
- Proactively identify areas for process improvement, innovation and opportunities for efficiency and synergy
- Manage vendor relationships by setting direction, measuring effectiveness and providing feedback on impact
- Partner collaboratively with colleagues of Berkley Medical Management Solutions and other Berkley operating units to ensure alignment of key client strategies and deliverables.
- Establish and maintain positive working relationships with co-workers, team members, leadership, vendors and the Berkley Sister Company’s to further BMMS mission and reputation in the managed care community.
- Prepare and review annual budget
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The Claims Supervisor directly reports to the Manager of the Claims Department and is an integral member of the Claims Leadership Team. The Claims Supervisor is responsible for the analysis and management of claim files within their unit. Supervision includes: claim assignments, coverage analysis, establishment of and adherence to action plans in claim files, reserve accuracy, effective negotiation and appropriate resolution. The Claims Supervisor is a mentor to not only the specific unit, but also the entire claims department and is available for consultation/discussion with staff as the primary responsibility. The Claims Supervisor is responsible for staff training and development. The Claims Supervisor will work closely with other members of Claims Leadership to insure the efficient and effective resolution of issues. The Claims Supervisor is charged with managing pending claims, improving file quality and controlling expenses. The Claims Supervisor will conduct the management of claims in the utmost of good faith in compliance with the rules, regulations and statutes of the WCAB and State of California. The Claims Supervisor is expected to function at a high level of expertise and competency, while consistently exercising good judgment and independent discretion. The Claims Supervisor is expected to support Company goals, Department Goals and advance Company values.
Responsibilities include:
- Direct management of staff of up to 6 examiners and their claim files
- Manage Loss Costs
- Manage Loss Expenses
- Analyzes file plans
- Approve action plans in accordance with best practices
- Complete 10-day diary reviews on all new losses and maintain active diaries of all claims in the unit
- Document the claim file of all activities taken
- Work with the examiner throughout the life of the claim
- Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims
- Frequently communicate with all appropriate parties involved with the claim
- Maintain professional vendor relationships
- Actively execute appropriate claims activities to ensure consistent delivery of quality claims service
- Recommend staff payment and settlement authority for employees in unit
- Compliance with state laws and regulations regarding claim handling
- Shared responsibility for department budget, which includes planning and ongoing management of salary and expenses
- Claim Management as measured through aggressive action plans and overall supervision as measured by reduction in average paid and average age of cases at time of closing
- Other tasks assigned by the Vice President of Claims
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Investigates low to medium level commercial casualty claims in a prompt, equitable manner by analyzing coverage, liability/compensability and damages; evaluating reserves; and negotiating settlement or conclusion of claim.
- Examines and analyzes policies, contracts and claim forms to determine coverage.
- Investigates loss in a prompt manner by on-site investigation, telephone, or correspondence to determine the extent of the Company’s liability. Requests necessary reports, e.g., police reports, fire reports, medical records, property damage inspections, etc. Utilizes independent adjusting services to assist in the claim investigation as appropriate.
- Establishes accurate claim reserves and re-evaluates exposures and reserves during the life of the claim. Correctly enters claim data and file documentation into claim and related systems for reporting purposes.
- Negotiates settlement or conclusion of claim.
- Participates in educational, coaching and mentoring opportunities to enhance claims adjusting skills and knowledge.
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Overview
Curious negotiators who always go for the win-win.
Work on a team that provides world-class claim management and managed care solutions.
You will utilize intelligent technology to deliver interactive risk management solutions.
As a Claims Representative, you will deliver BerkleyNet’s fast and easy customer experience, while investigating claims and negotiating the best outcome for both sides.
As a member of the Claims team, you will have a strong impact on our bottom line. Success in your role means success for the company.
Who we are…
BerkleyNet is an innovative and leading provider of workers compensation insurance and services. We were started in 2006 with the goal of delivering an easier solution for customers - driven by speed and simplicity. Since that time, we've developed a national presence and are recognized for our "Ridiculously Fast, Amazingly Easy" approach to workers compensation. If you are looking to join a fast-paced, energetic and passionate team with room for professional growth and development - BerkleyNet may be a great fit for you.
The BerkleyNet Way is…
- Fearlessly explores new paths
- Generates solutions and positive energy
- Be a community builder
- Be an original
- Embrace ownership and adaptability
- Responsiveness is our reputation
- Communicate openly and share knowledge
- Integrity is non-negotiable
Responsibilities
- Research learn and apply worker's compensation statutes
- Investigate claims as reported and determine eligibility for benefits and administer benefits as warranted
- Address client issues and respond to inquiries promptly
- Manage the progression of the claims process through collaboration with physicians, nurses, attorneys and other parties as needed
- Analyze and process claims with the ability to have ownership of policy and claim transactions
- Translate data and understand department processes, functionality and requirements
- Maintain compliance with federal and state regulations
- Must be able to work independently and within a team environment
- Performs other related duties as required and assigned
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The Underwriting Assistant will provide general operational support to the Department including the processing of policies, endorsements, submissions and other client related correspondence for new and existing accounts.
RESPONSIBILITIES:
• Sends requests for additional information (inspection reports, financials, audits)
• Policy creation, binding, and issuance
• Issues notices of cancellation or reinstatement within authority
• Processing of endorsements and related correspondence
• Provides reports upon request
• Responsible for maintaining documentation in all Underwriting files
• Provides backup support for clearance processing
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The PremiumAudit Assistant is responsible for administrative functions within the audit department. The primary role of the Premium Audit Assistant will be to maintain and improve the premium audit department by performing the following duties: providing customer service support, processing incoming/outgoing mail, working with in-house premium auditors and fee audit vendors to insure the timely return of field audits, reviewing and entering audit invoices, preparing payroll audit worksheets as necessary and other general duties as assigned and deemed necessary.
Responsibilities include:
- Answer customer service calls regarding a variety of issues related to Underwriting, Premium Accounting and Audit.
- Process incoming/outgoing mail including audits received in our premium audit system, PATS
- Obtain audit statuses and assist auditors with the timely return of field audits and resolving any customer issues.
- Review and enter audit invoices.
- Maintain and keep current files of fee audit vendors.
- Prepare payroll audit worksheets as necessary.
- Assist premium audit analysts by providing administrative support.
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Works with the Regional Underwriting team to establish and achieve agency and team goals and objectives. Provides significant input into the development execution of team and line of business plans.
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BASIC FUCTION AND SCOPE:
Under limited supervision, reviews, evaluates, negotiates and processes WC Claims of serious to significant complexity, makes recommendations for resolution, and litigation management as appropriate. Has contact with agents, claimants, and policy holders.
MAJOR RESPONSIBILITIES:
- Responsible for the day to day management of serious to complex workers compensation claims.
- Conduct initial investigation to confirm coverage is in place for the loss and that the loss itself is compensable per state specific requirements, make quality, prompt contacts with employer, claimant, doctor and any witnesses, document and confirm initial diagnosis and prognosis.
- Ensure that the claim is adequately reserved, review and pay medical bills and expense bills timely and accurately, recognize and evaluate each case for subrogation potential, recognize potential fraud cases, document return to work and light duty efforts, accurately calculate, code and issue indemnity payments, promptly and accurately complete required internal Large Loss reports.
- Proactively manage all litigated claims by clearly documenting the litigation plan and budget, retaining competent counsel, communicating with counsel on a regular basis and clearly documenting the litigation action plan and strategy.
- Participate in claim reviews, which may require some travel.
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The Assistant Vice President, Business Partner reports to the Vice President, Business Partner of BTS. This role supports the Regional and Alternative Segment, and their respective leadership teams. The focus is ensuring delivery of technical solutions, demand management and change management in alignment with business objectives.
- Alignment: Accountable for ensuring technical recommendations and solutions appropriately consider and balance Segment, Operating Unit, Corporate and BTS objectives and capabilities
- Communication: Accountable for communication between operating units and all IT teams to ensure alignment of business capabilities to technology, priorities, timelines and readiness.
- Partner: Be a trusted partner in delivery to the segment and all technology teams
- Strategy: Partner with segment IT leadership to understand and align technology support to strategic outlooks
- Demand Management: Own the process for intake and prioritization across operating units, technology teams and governance groups. Resolve relative priority conflicts across competing interests. Accountable for aligning demand with approved spend and partnering with operating units on business case development when additional funding is necessary.
- Change Management: Develop, facilitate, coordinate and communicate change management for the segments in support of enterprise initiatives. Change management is inclusive of business and technical plans for new system implementations and legacy system sunsets.
- Governance: Partner with operating units and IT Finance on business case development and project governance
- Delivery: Coordinate the delivery of tasks across technology teams in alignment with business initiatives. Ensure major milestones are documented, understood and managed.
- Financial Planning and Reporting: Accountable for BTS expenses being managed in alignment with segment financial plans and forecasts. Report and manage BTS expenses within overall context of segment expenses monthly.
Escalation and resolution: Perform as the single point of escalation, and facilitate resolution for all issues relative to IT in support of segments and BTS.
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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 Pollution, Professional Liability, General 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
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- Conduct complete investigation of losses through appropriate techniques including interviews, recorded statements, documentation/data gathering and securing/preserving evidence.
- Evaluate compensability and exposure; identify subrogation opportunities or suspicious claims. Prepare timely, concise reports and state filings as required by the jurisdiction. Promptly establish and maintain accurate reserves. Adhere to state regulatory compliance requirements.
- Verify, analyze, and correctly apply coverage.
- Demonstrate appropriate use of Peer Reviews, Retrospective Reviews, Utilization Review and other cost containment tools to effectively manage the indemnity and medical exposure.
- Develop strategy and negotiate claims to a timely conclusion, properly applying state compliance and company policies and procedures. Develop a resolution plan (e.g. pay, deny, dispute) based upon analysis of the facts, defenses, compensability, and statutory/case law.
- Determine need for and provide direction to defense counsel, nurse case managers or other technical experts. Monitor and control their costs. Attend mediations, hearings, pre-trial settlement conferences, trials, etc., as required.
- Keep policyholders, underwriting and agents advised of file status and other matters as required.
- Participation in presentations, meetings, or visits to agents, policyholders, prospective accounts and other groups related to claims resolution, service or technical issues.
- Generating and providing weekly, monthly, annual and ad hoc claim related reports required and as needed.
- Assist in researching statutory requests and/or financial/operational reporting requirements and providing details to management in an effort to assist with a response.
- Assist in the communication of current and new regulations by state related to claim handling throughout the claims organization.
- Successfully complete relevant continuing education as required.
KNOWLEDGE, SKILLS & ABILITIES
- Bachelors degree preferred
- Minimum 5 years' experience adjusting Workers' Compensation lost time claims.
- Solid technical knowledge of Workers' Compensation laws for Texas and other jurisdictions
- Understand and appropriately apply legal concepts, practices, statutes, regulations and case law to claim handling.
- Strong negotiation skills leading to best claim outcomes.
- Work independently and exercise sound judgment.
- Must be highly organized with ability to handle multiple tasks simultaneously to meet deadlines.
- Ability to follow detailed procedures and ensure accuracy in documentation and data.
- Ability to communicate effectively with people from all backgrounds and uphold a high standard of customer service.
- Must be highly organized with ability to handle multiple tasks simultaneously to meet deadlines.
- Ability to follow detailed procedures and ensure accuracy in documentation and data.
- Ability to present information through the spoken or written word; listen well.
- Ability to Mink critically and solve problems, including the ability to interpret related documentation.
- Demonstrate proficiency in computer programs, such as Microsoft Word, Outlook and Excel
COMPETENCIES
- Analytical Thinking
- Decision Making/Problem Solving
- Attention to Detail
- Ownership/Accountability
- Prioritization/Time Management
- Communication
- Customer Focus
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The Underwriting Operations department of Nautilus Insurance Group has a Temporary Position available. The role will be processing inbound correspondence from our Underwriters and Agents.
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The Senior Underwriter will work in a team setting generating, underwriting and analyzing accounts for development of new and renewal commercial casualty business.
RESPONSIBILITIES:
- Compliance with underwriting documentation rules and guidelines.
- Maintain an acceptable underwriting profit.
- Adherence to Admiral underwriting guidelines and referral compliance.
- Development and maintenance of key broker/agent relationships.
- Participates in all internal company training and continuing education.
- Remains current on product releases as it pertains to Commercial Casualty.
- Leads strategic marketing calls to key brokers (up to 25%).
- Management and development of business and broker relationships new to the organization.
- Stay abreast and knowledgeable on market trends in terms of forms, coverage and appetite to maintain competitiveness.
- Active mentorship and training of Associate Underwriters and Underwriters.
- Act as a referral authority for Associate Underwriters and Underwriters.
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The Claims Assistant reports to the Claims Manager and performs administrative duties for claim handlers and supervisors in accordance with company standards, procedures and state regulatory requirements. Essential duties and responsibilities include but are not limited to:
- Completing input of first reports, suits
- Types coverage position letters and other forms of correspondence
- Uses EXCEL or WORD to complete projects for the Claims Department, when requested
- Maintains activity records and completes monthly reports
- Maintains and controls check issuance as required. Pays bills, files forms, ensures that required regulatory letters are sent out, photocopies.
- Inputs data, processes checks and mails out same
- Handles incoming calls and performs customer service functions
- Performs duties in conjunction with claim departments Best Practices guidelines
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Member of Corporate Compliance Department that is responsible for the following:
- Market Conduct/State Exams & Inquiries
- Delaware Triennial Exam Process
- Anti-Fraud Plans/SIU Compliance Program/Vendor Management
- State Insurance Department Data Calls
- NCCI/State Workers Compensation Data Reporting
- Agency Appointment Process/Renewal Fee Processing – Centralization Project
- State insurance Department - Consumer Complaints
- Domestic and International Company Licensing matters
- Development and communication of various corporate compliance policies/procedures
- Miscellaneous Corporate Projects
Overall Responsibilities:
- Work with the various operating units and financial reporting unit to collect data and complete state insurance department data calls for various WRBC statutory companies
- Handle/coordinate state market conduct examinations/regulatory inquiries – including interaction with regulatory examination staff
- Coordinate anti-fraud training/state insurance department fraud plan filings with outside vendor
- Work with operating units to coordinate loss control plan filings with state insurance departments
- Work with operating units to coordinate agent appointments and annual renewal fee payments
- Handle miscellaneous insurance regulatory matters/questions raised by operating units
- Help maintain Corporate Compliance intranet site
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- Assist in entering, updating and monitoring jobs in Risk Services tracking system
- Identify, track and initiate all compliance related jobs and requirements
- Communicate with others across the organization
- Prepare loss runs for state compliance, insured and agent requests
- Support Risk Services consultants, as needed
- Evaluate changes to state compliance regulations and effectively update internal practices as a result
- Review current practices and identify gaps, efficiencies and proactively work to implement changes
- Run MVR’s for company
- Assist in managing online training platform content
- Process renewal submissions
- Provide administrative support, as needed
- Other duties as required