Claims Examiner II

Claims Examiner I Or II

Nautilus Insurance is seeking a Claims Examiner I or II to join our team. This role can be located in our Scottsdale office or remotely for a highly qualified candidate.

The Claims Examiner I's primary job function includes efficiently and effectively handling primarily basic third-party general liability losses in a "paperless" environment. The assigned caseload may include up to one-half intermediate-level losses. An ability to communicate both verbally and in written form in a prompt, courteous and professional manner is essential.

• 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 continues 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 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 a basic and frequently higher 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 in a regular and timely basis Large Loss Reports and other detailed reporting documents as appropriate.

• Manages and monitors file caseload through the use of various resources.

• Obtains all required state adjuster licenses and maintain them as required via compliance with mandatory continuing education requirements.

• Demonstrated experience working with business users.

• Other duties may be assigned.

• Occasional participation in projects and initiatives lead by other departments and/or W. R. Berkley companies, including audits, workshops, focus groups, task forces, etc.

• Initiates appropriate communication with members of management and other Departments.

• Attends internal and external seminars and other training events and provide feedback to peers and/or members of management.

Qualifications

• Must have at least five (5) years of insurance experience.
• Certificates as required by states.
• Must have intermediate knowledge of computer programs in a Windows environment, including Word, Excel and E-mail.

Education Requirement

• High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience. Some college preferred. CPCU, AIC, AEI or completion of other insurance-related classes is preferred.

Additional Company Details

The Company is an equal employment opportunity employer. We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role