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Nonprofits Insurance Alliance (NIA) · 3 weeks ago

Senior Claims Examiner (Auto/General Liability Focus)

United States

Full-time

Remote

Senior Level, Lead/Staff

$85K/yr - $170K/yr

10+ years exp

Nonprofits Insurance Alliance (NIA) is the nation’s leading property and casualty insurer exclusively serving nonprofit organizations. The Senior Claims Examiner manages complex claims, investigates and resolves them while ensuring compliance with company policies and state laws, and works independently as well as directs other professionals when necessary.

Financial ServicesInsurance

Responsibilities

Determines coverage(s) applicable to loss

Investigates, manages and resolves claims in a timely, unbiased and informed manner in compliance with company policies, state laws and regulatory performance standards

Sets and maintains adequate claim reserves based on facts of case and in accordance with company policy

Conducts investigation, assigning fieldwork as necessary and appropriate, in accordance with company standards

Determines liability

Evaluates and pays claims within designated authority

When requested, present coverage and claims analysis to management and make recommendations on resolution of disputed items

Set reserves up to the positions level of authority

Prepares and presents verbal and written claim status reports in accordance with company policy and pursuant to Reinsurance treaty requirements

Recommends payment, evaluates and reserves claims and reports to manager cases in excess of designated authority, as well as to Reinsurers pursuant to treaty requirements

Manages legal aspects through timely assignment of litigated cases to defense counsel, and on-going evaluation of legal process and expenses

Maintain electronic files necessary for documentation of the claim file

Analyzes and regularly reports to Claims Manager on the performance of defense counsel

Represents the company at litigation related settlement conferences, mediation, and arbitration when needed

Works closely with outside counsel to monitor claims and work with insureds to resolve underlying litigation

Participates in both internal and external audits as needed

Participates in weekly department meetings and Claims Committee Meetings as needed

Promote the team approach to case and account management

Participates in marketing presentations and training programs as needed

Provide accurate, courteous and timely information to all external and internal customers concerning claims status and other inquiries

Other duties as assigned

Qualification

Claims managementEmployment Practices LiabilityGeneral LiabilityTort law knowledgeNegotiation skillsCritical thinkingPC literacyCommunication skillsOrganizational skillsConflict resolution

Required

10+ years carrier experience

Ability and willingness to obtain adjuster licenses as needed in various states

Thorough knowledge of current tort law and case law trends with respect to all casualty lines of business, civil procedure, insurance policy(s) and contract(s)

Good written and oral communication skills

Organized and possess strong follow-up skills

Ability to analyze and apply creative solutions to claim issues

Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details

Strong negotiating skills

Excellent telephone, written and verbal communication skills

Objectivity and pragmatism as well as strong conflict resolution skills

Ability to manage total loss cost outcomes including ALAE to achieve superior results for our members and the company

Awareness of and follow guidelines concerning confidentiality

Demonstrated capability for working with a high level of independence

Ability to deliver results in a fast-paced environment

Positive approach, can-do attitude, flexibility and ability to operate with grace under pressure

Ability to model and uphold appropriate professional boundaries in work with member-insureds

Interest and commitment to the mission of the organization

Commitment to inspired service

Communicate effectively orally and in writing

While performing the duties of this job, the employee is regularly required to bend, reach or sit for up to 3 hours at a time

Must have adequate vision (with corrective lenses, or other accommodative devices if needed) to clearly view computer screen

Must have adequate hearing to perform job tasks

Travel required as necessary and must be able to be productive while traveling on business, including the ability to utilize laptops and other business tools as provided, subject to reasonable accommodation, if needed

Ability to mentor peer groups or more junior claims staff, as requested

Four year college degree or equivalent business experience