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The Senior Software Developer is Responsible for the design, development, maintenance and enhancement of applications utilized by Admiral Insurance and its business partners. Develop an application design that will satisfy the immediate requirement as well as provide opportunities for long-term expansion. Possess an ability to effectively explain the design to members of IT management and staff in both verbal and written forms. Complete research and development on new programming tools and third-party toolkits, and provide recommendations to IT Management regarding how to move forward with new technology. Act as a lead reference to the users of applications developed and maintained by the IT Department.
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Providing excellent customer service is a passion at Nautilus. We foster an environment that promotes creativity, integrity, and respect. Auditors collaborate with leadership, underwriting, agents, and insureds to clarify policy intent and ensure accuracy in rating structure.
Key Responsibilities:
- Audit of insured records to determine accurate premium due.
- Manage dispute resolution to determine if information is valid to warrant a revision, communicating directly with agents or insured’s to resolve the dispute.
- Act as primary resource to problem solve with internal and external customers regarding exposures, classification changes or general auditing procedure questions.
- Collaborate with leadership to enhance and improve product and work-flow philosophy.
- Interact with team-members to encourage and foster a positive work environment.
- Lead and complete special projects assigned by management to assist with corporate initiatives.
- Mentor, encourage and assist team in technical training.
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Handle the daily processing of disbursements for the Companies that we service while providing excellent customer service and maintain a high level of attention to detail.
- Processing of all disbursements for the Companies you are assigned through the invoice workflow system or interface files (claims, premium refunds, commissions).
- Coding of invoices and payment requests in Accounts Payable system.
- Assist with printing of checks and special handling.
- Respond to Company inquiries on payment and invoice submission.
- Provide excellent customer service.
- Verify approval on invoices and payment requests.
- Other duties as assigned.
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The Emcap Program Manager develops and manages trusted relationships with assigned captive programs, functioning as primary liaison, supporting the implementation of new programs and delivering reporting, analysis and making recommendations of best practices and health risk management approaches to mitigate financial exposure. Duties and responsibilities include but are not limited to:
- Developing and managing trusted relationships with assigned captive programs, including effectively interfacing with C-Suite and executive level business relationships at the policyholder, TPA, Broker, Captive and a variety of third parties.
- Functioning as primary liaison with Captive Manager and overseeing necessary captive deliverables to ensure timely cession reporting and member/consultant support.
- Coordinating and preparing monthly, quarterly and annual loss reporting packages, quarterly conference calls, and 1:1 report introduction calls, as well as supporting and presentating at regional and annual program meetings
- Developing and managing communication of results and performance of assigned captive programs to internal and external parties, including analysis of historical performance and interpretation of loss performance.
- Developing and managing surveys and voting for assigned captive programs.
- Working with distribution channel and captive members in development and implementation of risk management strategies and education of potential health risk management solutions/vendors.
- Supporting the launch of new captive programs including establishing the cession reporting, coordinating calls and logistics with Program Sponsor/Captive Manager to ensure a smooth implementation.
- Developing documentation/recommendation of processes and procedures to support efficiency and growth targets for the captive division.
- Effectively liaising with various operating areas including premium accounting, finance, and clinical team on behalf of policyholders and consultant brokers to ensure understanding of claims handling, premium processes, policy provisions/endorsements and understanding internal health risk management services.
- Managing vendor relationships to maintain smooth coordination between the parties (TPAs, disease management, broker, captive, members, etc.)
- In collaboration with AVP, overseeing the activities of account management team assigned to programs, including training, development, and input on performance reviews to ensure appropriate coordination of information and resources to achieve customer service standards. At times providing back-up and support in interfacing with broker, policyholder and TPAs.
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Serving in the Federal Government Relations office, the Federal Government Relations Manager will provide business and administrative support for the Vice President of Federal Government Relations, including managing regulatory compliance activities for federal governmental relations, conducting research, assisting in the preparation of presentations and summaries of legislation and policy issues of importance to the company, tracking progress of key Federal issues, including tax policy, and facilitating support of the company’s political action committee (PAC). The position also assists the Vice President of FGR in arranging and managing travel, preparation of documents for hearings, briefings, and coalition activities, and the management of administrative compliance matters including timesheets, office budget, and public disclosures.
- Oversee and mange process, assure timely filings of compliance reports such as the quarterly federal Lobbying Disclosure Act (LDA) and bi-yearly LD-203 Political Contributions report, including maintaining and updated Federal Government Affairs Budget.
- Build and maintain external relationships to further company reputation and continued political contacts; facilitate interactions between senior management, Congressional members and staff, as well as other external affiliates;
- Represent the company in legislative engagement activities and political activities and events.
- Identify and track issues with potential impact on the company and work with company subject matter experts for analyses; work with external stakeholders
- Research, analyze and prepare information and make recommendations as appropriate
- Assist in development and maintenance of federal policy goals and reporting of the Federal Government Relations team
- Assist in coordination of special events, meetings and other communications with Senior Management, Congressional delegations and staff as well as other external affiliates.
- Answer incoming calls in an exceptional, positive, clear manner, schedule appointments, organize staff and coalition meetings, support setting travel itineraries, maintain office supplies, expenses, filing and scanning documents, data entry, and coordinate pick-ups and deliveries
- Maintain confidentiality at the highest levels and protect sensitive data at all times.
- Take personal initiative to prepare drafts of correspondence and other documents required on a timely basis.
- Provide superior proof-reading expertise to members of Government Relations and related legal teams.
- Assist Federal Government Relations with the corporate political contribution process including internal approval process and drafting PAC requests.
- Demonstrate exceptional customer service and interacts effectively with all.
Essential Functions:
- Oversee and assure timely, accurate filings of compliance reports
- Identify and track issues, work with key subject matter experts and external stakeholders.
- Represent the company at external events.
- Assists in coordination of special events.
- Coordinate all Washington DC office administration.
- Maintain the Federal office budget.
- Assist federal PAC activity.
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The Human Resources Business Partner works closely with leaders to consult, provide advice and recommend guidance as it relates to talent-related activities such as recruitment and selection, staff retention, performance management, talent development, compensation planning and employee relations. As a strategic partner, works with leadership to align business objectives with the enterprise strategic initiative.
- Consults, counsels and strategizes with leaders on performance management, talent development, salary administration, succession planning, recognition, performance issues, disciplinary actions, training gaps, employee relations, etc. Explores and suggests appropriate actions and alternatives. Guides and coaches leaders through actions related to formal disciplinary procedures, jointly determines appropriate course of actions; reviews and provides suggestions for performance improvement plans; and ensures legal compliance with aid of in-house legal counsel. Partners with management to improve employee engagement, build morale and increase productivity and retention. Assists in administration and communication of FMLA and/or ADA process as needed.
- Confers with leaders to identify staffing needs, job specifications, job duties, qualifications, skills and competencies. Partners with internal recruitment staff on exempt, non-exempt and temporary positions. Partners with hiring managers to ensure proper department on-boarding and training plans are followed.
- Assists in the development and delivery of management and/or employee training sessions related to strategic initiatives, performance management, employee engagement, succession planning, etc. Actively researches, creatively designs and implements effective methods to educate, enhance performance and recognize performance. May lead or participate in special and/or cross-functional project teams related to Company and/or Human Resources initiatives. Develops and maintains productive relationships throughout the Berkley organization.
- Identifies, evaluates and resolves employee relations issues such as employee complaints, harassment allegations and civil rights complaints. Interviews employees, witnesses and management to gather and document facts relating to allegations. Evaluates issues and possible responses with assistance in-house legal counsel. Implements and documents appropriate intervention to facilitate resolution of the issue. Ensures company’s response complies with Federal, State and local laws. Initiates appropriate follow up with employee and management to communicate intervention and determine its effectiveness.
- Performs employee relation activities, e.g., responding to inquiries regarding policies, procedures and programs; reviews exit interviews to analyze reasons for separation and identify trends. Assists employees with developing personal strategies or action plans related to the workplace, e.g., career development, performance improvement, peer/manager conflict, communication, etc.
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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 policyholders. The position is located in our Jersey City Office.
Duties and Responsibilities:
- Analyzing and processing workers’ compensation claims by investigating and gathering information to determine the exposure on the claims involving multiple jurisdictions with a concentration in the Tri-State area.
- Calculates and assigns timely an appropriate reserve to claims and continues to manage reserve adequacy throughout the life of the claim.
- Develops and manages claims though well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution.
- Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level.
- Prepares necessary state filings within statutory limits.
- Actively manages the litigation process; ensures timely and cost-effective claims resolution.
- Participate in claim reviews, which will require limited travel.
- Coordinates vendor referrals for additional investigation and/or litigation management.
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
- Managing claim recoveries of all types, including but not limited to subrogation, Second Injury Fund recoveries, and Social Security offsets.
- Frequently communicates with all appropriate parties involved with the claim.
- Maintains professional client relationships.
- Actively executes appropriate claims activities to ensure consistent delivery of quality claims services.
- 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.
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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. The position will be located in our Walnut Creek, CA office or be a remote position for the candidate given their experience and geographic location.
Duties and Responsibilities:
- Analyzing and processing workers’ compensation claims by investigating and gathering information to determine the exposure on the claims involving state of California.
- Calculates and assigns timely an appropriate reserves to claims and continues to manage reserve adequacy throughout the life of the claim.
- Develops and manages claims though well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution.
- Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level.
- Prepares necessary state filings within statutory limits.
- Participate in claim reviews, which will require some limited travel.
- Actively manages the litigation process; ensures timely and cost-effective claims resolution.
- Coordinates vendor referrals for additional investigation and/or litigation management.
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
- Managing claim recoveries of all types, including but not limited to subrogation, Second Injury Fund recoveries, and Social Security offsets.
- Frequently communicates with all appropriate parties involved with the claim.
- Maintains professional client relationships.
- Actively executes appropriate claims activities to ensure consistent delivery of quality claims services.
- 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.
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As a strategic partner, the HR Manager works with the Vice President of Human Resources (VP HR) and Operating Unit Leadership to align and support the VP HR with the execution of the talent strategy and operating unity strategic initiatives. This role works closely with Leadership and Group HR to consult, provide advice and guidance as it relates to talent-related activities including but not limited to: recruitment and selection, staff retention, performance management, talent development, compensation planning and employee relations.
The HR Manager fulfills the primary responsibilities of the role by executing the following duties and tasks:
- Consults and counsels with leaders on performance management, talent development, salary administration, succession planning, recognition, training gaps, employee relations, employee conduct, etc.
- Guides and coaches leaders through actions related to formal disciplinary procedures, jointly determines appropriate course of actions; reviews and provides suggestions for performance improvement plans; and ensures legal compliance with aid of VP HR and/or legal counsel when necessary
- Proactively identifies areas for process improvement, innovation, and opportunities for efficiency and synergy
- Partners with management to improve employee engagement and increase productivity and retention, this includes coordination of community or company events, e.g.
- Confers with leaders to identify staffing needs, job specifications, job duties, qualifications, skills and competencies
- Partners with recruiting on internal and external recruitment efforts for all positions
- Partners with hiring managers to ensure proper department on-boarding tasks including: 30/60/90 day reviews, survey analysis, etc.
- Partners with the hiring manager to ensure required timely completion of new hire I-9’s; and finding alternative sources to complete new hire’s I-9 for off-site/remote/employees. Updating I-9 verifications in HireRight as required.
- Assists in the development and delivery of management and/or employee training sessions related to strategic initiatives, performance management, employee engagement, succession planning, etc.
- Actively researches, creatively designs and implements effective methods to educate, enhance performance and recognize performance; advising and collaborating on the development and administration of recognition programs with Group HR
- May lead or participate in special and/or cross-functional project teams related to Company and/or TCR strategic initiatives
- Identifies, evaluates and resolves employee relations issues such as employee complaints, harassment allegations and civil rights complaints
- Conducts, Analyzes and reports on trends related to employee relations activities; Reviews exit interviews to analyze reasons for separation and to identify trends
- Assists employees with developing personal strategies or action plans related to the workplace, e.g., career development, performance improvement, peer/manager conflict, communication, etc.
- Administers initial and ongoing Visa and Immigration requirements
- Administers one – time – payments in Workday including: Sign On Bonus/Severance/Tuition Reimbursements
- Additional duties as assigned
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The International Underwriting Manager is a key contributor within the Berkley Global Underwriters organization responsible for the design, development and implementation of international underwriting strategy, policy forms/structure, training and consultation. Ideal office locations include Ewing and Morristown, NJ but other W. R. Berkley US office locations can be considered for well qualified candidates for the role. Specific duties and responsibilities include but are not limited to:
- Serves as part of leadership team charged with the continued development and implementation of an integrated global network and infrastructure.
- Drafts policy contracts, attending documentation, and related correspondence for international exposures.
- Assists underwriters and Legal in addressing issues related to contract wording.
- Assists and trains underwriters addressing issues related to local coverage concerns
- Participates in development of marketing support for product offerings.
- Designs tools and procedures to support the execution of local admitted policies for multiple placement options.
- Engages, educates and influences multiple constituents, both overseas and domestic, on procedures to access global network.
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Accepts, retains and prices moderate to high exposure commercial property and casualty insurance accounts in accordance with established underwriting guidelines and within delegated authority level. Manages assigned territory to achieve profitable growth objectives by properly classifying and pricing risks; building strong internal and external business relationships; analyzing competitive marketing data, identifying territory needs; and developing, implementing and monitoring action plans as appropriate. Serves as an underwriting resource by providing knowledge and insight to underwriting staff.
- Reviews renewal accounts by examining business operations, classification, contract forms and loss activity. Determines if account is an acceptable risk or if it will be non-renewed. Determines price in accordance with established underwriting guidelines and within delegated authority level. Reviews endorsement requests exceeding Underwriter and/or Underwriting Assistant’s authority level and takes appropriate procedural action.
- Assesses new commercial insurance risks and determines accurate classification of business, policy contract forms and pricing of risk. Works within broad limits and authority on commercial underwriting accounts of moderate to high exposure. Evaluates MVRs, financial reports, loss control reports, etc. Accepts and prices risk in accordance with established underwriting guidelines and within delegated authority level.
- Develops, expands and/or enhances agency relationships to promote profitability and growth of new business and the retention of existing business. Travels assigned territory and meets with agents to enhance business relationships. Educates agency staff on Company’s pricing and risk selection philosophy. Participates in the agency management process. Assesses the strengths and weaknesses of agencies and assists them in achieving the mutual goal of sustained profitable growth.
- Works in partnership with regional Business Development staff to identify new business opportunities from the agency force to assess, quote, inspect and accept. Collaborates to classify agencies within established marketing segments; analyze territory’s mix of business, production, and loss experience; establish agencies’ annual premium goals; and conduct quarterly and annual review of agencies’ profit and growth results.
- Effectively manages assigned territory to achieve established profitability, growth and retention goals. Analyzes agency results and competitive marketing data to identify trends and opportunities. Develops, implements and monitors action plans as appropriate. Monitors and reports on material changes within the territory’s legal environment. Reviews industry periodicals and journals, legislative actions and court decisions to develop a broader industry awareness and understanding of competition within the territory.
- Serves as underwriting resource to underwriting staff and agents regarding products, coverages and rating procedures. Provides professional development knowledge and guidance to Underwriter Trainees, Underwriters, Underwriting Assistants and other functional areas.
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Accepts, retains and prices moderate to high exposure commercial property and casualty insurance accounts in accordance with established underwriting guidelines and within delegated authority level. Manages assigned territory to achieve profitable growth objectives by properly classifying and pricing risks; building strong internal and external business relationships; analyzing competitive marketing data, identifying territory needs; and developing, implementing and monitoring action plans as appropriate. Serves as an underwriting resource by providing knowledge and insight to underwriting staff.
- Reviews renewal accounts by examining business operations, classification, contract forms and loss activity. Determines if account is an acceptable risk or if it will be non-renewed. Determines price in accordance with established underwriting guidelines and within delegated authority level. Reviews endorsement requests exceeding Underwriter and/or Underwriting Assistant’s authority level and takes appropriate procedural action.
- Assesses new commercial insurance risks and determines accurate classification of business, policy contract forms and pricing of risk. Works within broad limits and authority on commercial underwriting accounts of moderate to high exposure. Evaluates MVRs, financial reports, loss control reports, etc. Accepts and prices risk in accordance with established underwriting guidelines and within delegated authority level.
- Develops, expands and/or enhances agency relationships to promote profitability and growth of new business and the retention of existing business. Travels assigned territory and meets with agents to enhance business relationships. Educates agency staff on Company’s pricing and risk selection philosophy. Participates in the agency management process. Assesses the strengths and weaknesses of agencies and assists them in achieving the mutual goal of sustained profitable growth.
- Works in partnership with regional Business Development staff to identify new business opportunities from the agency force to assess, quote, inspect and accept. Collaborates to classify agencies within established marketing segments; analyze territory’s mix of business, production, and loss experience; establish agencies’ annual premium goals; and conduct quarterly and annual review of agencies’ profit and growth results.
- Effectively manages assigned territory to achieve established profitability, growth and retention goals. Analyzes agency results and competitive marketing data to identify trends and opportunities. Develops, implements and monitors action plans as appropriate. Monitors and reports on material changes within the territory’s legal environment. Reviews industry periodicals and journals, legislative actions and court decisions to develop a broader industry awareness and understanding of competition within the territory.
- Serves as underwriting resource to underwriting staff and agents regarding products, coverages and rating procedures. Provides professional development knowledge and guidance to Underwriter Trainees, Underwriters, Underwriting Assistants and other functional areas.
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Accepts, retains and prices moderate to high exposure commercial property and casualty insurance accounts in accordance with established underwriting guidelines and within delegated authority level. Manages assigned territory to achieve profitable growth objectives by properly classifying and pricing risks; building strong internal and external business relationships; analyzing competitive marketing data, identifying territory needs; and developing, implementing and monitoring action plans as appropriate. Serves as an underwriting resource by providing knowledge and insight to underwriting staff.
- Reviews renewal accounts by examining business operations, classification, contract forms and loss activity. Determines if account is an acceptable risk or if it will be non-renewed. Determines price in accordance with established underwriting guidelines and within delegated authority level. Reviews endorsement requests exceeding Underwriter and/or Underwriting Assistant’s authority level and takes appropriate procedural action.
- Assesses new commercial insurance risks and determines accurate classification of business, policy contract forms and pricing of risk. Works within broad limits and authority on commercial underwriting accounts of moderate to high exposure. Evaluates MVRs, financial reports, loss control reports, etc. Accepts and prices risk in accordance with established underwriting guidelines and within delegated authority level.
- Develops, expands and/or enhances agency relationships to promote profitability and growth of new business and the retention of existing business. Travels assigned territory and meets with agents to enhance business relationships. Educates agency staff on Company’s pricing and risk selection philosophy. Participates in the agency management process. Assesses the strengths and weaknesses of agencies and assists them in achieving the mutual goal of sustained profitable growth.
- Works in partnership with regional Business Development staff to identify new business opportunities from the agency force to assess, quote, inspect and accept. Collaborates to classify agencies within established marketing segments; analyze territory’s mix of business, production, and loss experience; establish agencies’ annual premium goals; and conduct quarterly and annual review of agencies’ profit and growth results.
- Effectively manages assigned territory to achieve established profitability, growth and retention goals. Analyzes agency results and competitive marketing data to identify trends and opportunities. Develops, implements and monitors action plans as appropriate. Monitors and reports on material changes within the territory’s legal environment. Reviews industry periodicals and journals, legislative actions and court decisions to develop a broader industry awareness and understanding of competition within the territory.
- Serves as underwriting resource to underwriting staff and agents regarding products, coverages and rating procedures. Provides professional development knowledge and guidance to Underwriter Trainees, Underwriters, Underwriting Assistants and other functional areas.
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The Claims Examiner Trainee, is the first working professional level of claims handling. Under close supervision, the Claims Examiner Trainee will receive in depth training of department objectives, and workers’ compensation laws to be able to administer basic claim benefits. The training will consist of learning to handle simple medical only claims to handling complex medical only claims, involving non-litigated, minimal lost time, soft tissue type injuries. Other items handled include strain/sprain injuries due to repetitive motion and minor indemnity disability claims. The Claims Examiner Trainee will ultimately be able to determine compensability and handle uncomplicated claims issues on assigned claims. Claims handling activities will be performed in compliance with the rules, regulations and statutes of the WCAB and the State of California.
Responsibilities include:
- Provide customer service – answer telephones by the third ring and re-direct callers as necessary to properly respond to customer inquiries.
- Complete three-point contact to properly investigate assigned claims, evaluate coverage and determine compensability.
- Calculates and assigns timely and appropriate reserves to claims and continues to manage reserve adequacy throughout the life of the claim.
- Develops and manages claims through well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution.
- Negotiate outstanding liens on settled claims.
- Complete assigned work via diaries and work queues in a timely manner.
- Appropriately initiate QME and Voucher process for unrepresented claims.
- Perform other duties as requested by manager.
Key Accountabilities:
- Investigation (Measured through the timeliness and quality of 3 point contacts and addressing of such issues as coverage, compensability, delay and/or denial of claim, subrogation, contribution, apportionment.)
- Reserving (Measured through timely establishment and/or amendment of reserves using the philosophy of “most likely outcome.”)
- File Management (Measured through the establishment, documentation, and execution of action plans.)
- Medical Management (Measured through collaborative effort with the Medical Management Unit.)
- Procedures (Measured through timely and accurate State filings, payment of bills, and appropriate coding.)
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A new position for a Data Management Coordinator has opened in the Data Management department at BerkleyMed. The Data Coordinator plays a crucial role in the preparation of data before it is entered into internal systems. The preparation and entry of this information is a key differentiator of our organization, which is used across numerous disciplines within BerkleyMed. With its expansive database of claims, BerkleyMed is the leading provider of data and analytics solutions in the industry, which is used to help hospitals identify opportunities to improve the care they deliver to their patients.
If you’re the right person for this opportunity, you will work well on a team, be someone others can count on, and have a genuine love of learning. If you desire to work in an environment where your voice matters, you have an active influence on the direction of the company, and you can play an important role in revolutionizing the industry, then this may be the opportunity for you. This is an immediate opening, reporting to the Data Management Leader, who will oversee the position and set targets. This full-time role is based in Chesterfield, MO.
- Triage incoming claim information to ensure the highest risk claims are prioritized first
- Enter claim data into the claims system for easy reference when it is needed
- Input requests for insurance by entering information into the CRM system (Salesforce)
- Prepare and review claims from potential insureds for further analysis by actuarial and analytics teams
- Identify and communicate unusual findings to data consumers
- Perform administrative duties including: answer main phone, receive deliveries, order office supplies, and receive, sort, and distribute mail
- Assist with special projects as assigned to meet the needs of our internal and external users
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A new position for Salesforce Administrator has opened in the Information Technology department at BerkleyMed. The Salesforce Administrator plays a crucial role in the implementation, maintenance, and security of BerkleyMed’s CRM system. The Salesforce system is an integral component of our day-to-day operations and is a key organizational and collaboration tool used across numerous disciplines within BerkleyMed.
If you’re the right person for this opportunity, you will have the courage to share your ideas, work well on a team, and have a genuine love of learning. If you desire to work in an environment where you have a voice that matters, autonomy in how to perform your functions, and an active influence on the direction of the company, then this may be the opportunity for you. This is an immediate opening, reporting to the Information Technology Leader, who will oversee the position and set targets. This full-time role is based in Chesterfield, MO.
- Collaborate with Business Process Analyst to develop, test, and deploy solutions that meet user needs
- Train users and respond to questions to facilitate the consistent and appropriate use of the system
- Identify and resolve current and/or potential problems as they arise to create a seamless experience for users
- Prioritize incoming requests in support of the Salesforce strategy and roadmap
- Make recommendations for future developments to support the long-term improvement and advancement of the CRM tool
- Assist with special projects as assigned to meet the needs of our internal and external users
- Assist with the development of tools to create more efficient processes throughout the organization
- Act as a liaison between BerkleyMed and technology team to resolve IT related issues
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The Unit Manager has joint responsibility with the Vice President for technical supervision, training and continued development of claims personnel, in addition to handling a personal diary.
RESPONSIBILITIES:
- Train unit personnel in the areas of claims investigation, reserving, evaluation, negotiation, and settlement.
- Assure compliance with departmental policies and practices concerning file creation, documentation and report preparation. Report preparation includes large/severe claims reports, and file memos.
- Train examiners/superintendents to properly conduct an accurate, comprehensive coverage analysis.
- Consult with Underwriting regarding policy construction and underwriting intent, etc.
- Create and maintain an override diary.
- Perform file reviews as required.
- Participate in WRBC Claims quality audits as needed
- Participate in marketing calls/visits as needed
- Attend industry related seminar workshops and/or courses for continuing education
- Additional projects as assigned.
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The Senior Claims Examiner efficiently and effectively handling intermediate-level, commercial first -party property and/or third-party general liability (GL) losses.
- Reviews and sets up new loss assignments in a timely manner in compliance with department guidelines and best practices.
- Establishes appropriate initial loss and expense reserves and continue to regularly evaluate the file for adequacy, accuracy and adherence to reserving guidelines.
- Analyzes and interprets policy language in conjunction with specific loss facts to reach appropriate coverage decisions.
- Drafts frequent and complex coverage correspondence, including reservation of rights and coverage disclaimers in compliance with various state statutes and regulations.
- Composes a variety of other detailed correspondence to insureds, claimants, attorneys, agents and regulatory agencies.
- Pro-actively 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.
- Obtains all required state adjuster licenses and maintains them as required via compliance with mandatory continuing education requirements.
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Carolina Casualty is seeking an Actuarial professional who has a passion for pushing the limits of their actuary knowledge. This role offers more variety and exposure to the business than a typical actuarial role. The ideal candidate will have the drive to lead projects, provide meaningful insights into the business impact of changes in actuarial analyses, processes, and/or analytical methods. The position requires strong programming and model building skills.
Principle Responsibilities
- Contribute to rate level targeting by assisting in the design, construction, and implementation of tools and processes for assessing rate adequacy.
- Perform regular rate level adequacy reviews of various lines of business and coverages. Make recommendations to the company Actuary.
- Help review, develop and maintain the company’s proprietary rating models.
- Support the company’s rating plans, rates, factors, and pricing tools, including providing actuarial support of state rate filings.
- Assist in the continued development and maintenance of the company’s actuarial database.
- Work with other departments in a company-wide effort to improve company efficiency.
- Develop data sets for predictive modeling. Participate in predictive modeling efforts. Recommend data elements and structures for adding value to the analysis.
- Contribute to the regular business monitors including required corporate reporting. Assist in improvement and development of new reporting to help others better understand the business.
- Assist the Actuary with the quarterly reserve analysis. This includes the development of Schedule P as well as actuarial supported financial exhibits.
- Work with the underwriters on the modeling of individual accounts as necessary.
- Assist other departments with technical needs as necessary.