LocationEncino CategoryClaims Exempt/Non-ExemptExempt Full-Time/Part-TimeFull-Time Description
Position Description: Claims Manager analyzes coverage for complex claims submitted under the applicable policy form. The duties of a Claims Manager include discussing claim facts and coverage issues with insureds, defense counsel and/or coverage counsel, and reinsured clients, particularly on more complex matters. Duties also include managing reinsurance programs; this entails training and supervising of claims examiners. Claims Manager must possess critical thinking and strong oral/written communication skills.
Essential Duties and Responsibilities:
- Takes responsibility for training and supervising of Claim Examiners as needed
- Performs file audits and employee performance reviews and makes recommendations
- Reviewing submitted claims for coverage, and making a determination as to whether a matter is covered under the applicable policy.
- Independently investigating complex claims and coverage issues.
- Independently review examiners' action plans, including coverage recommendations, and verify appropriate action is taken.
- Establishing and revising claim reserves based on claim developments and counsel liability assessments.
- Issuing coverage determination letters, including reservation of rights and denial letters.
- Appointing and liaising with defense and/or coverage counsel, as appropriate.
- Obtaining updates from defense counsel and/or coverage counsel and/or the Insured, as appropriate.
- Authorizing settlements based on liability and other considerations within settlement authority provided by Underwriters or reinsured client.
- Conduct detailed bill reviews to ensure appropriate payment.
- Maintaining a claim file by accurately documenting all communications, activity, etc.
- Communicate with brokers or reinsured clients to obtain information necessary for processing claims.
- Attending mediations, arbitration, etc. as needed.
- Managing reinsurance programs.
- Negotiating claims-handling protocols with reinsured clients and drafting the same based on agreed to terms.
- Updating senior claims staff and the Reinsurance Team on program developments and reinsured client feedback; advising examiners of same, if appropriate.
- Attending meetings with reinsured clients.
- Strong leadership and management skills
- Extensive written and verbal communication skills are needed to provide proper supervision of claims activities
- Ability to use computer software and database applications related to claims services
- Strong typing skills
- Excellent customer service and communication (verbal and written) skills
- Attention to detail
- Time management skills; ability to assist examiners in prioritizing their workloads
- Demonstrates a high level of professionalism with co-workers, management and clients
Education and Experience:
- Bachelor's degree is required
- Knowledge of Microsoft Office
- Previous experience as Senior Claims Examiner
- A minimum of 12 years of handling claims experience
- A minimum of 5 years of managing or supervising claims personnel
Please direct any questions to [email protected] Req NumberCLA-17-00010 About the OrganizationNAS is not your typical insurance company. We're a specialty insurance underwriter with a strategic relationship to Lloyd's, London. We create unique insurance products for businesses, like cyber insurance, and provide a range of services to carriers, brokers and policyholders to help them work smarter. We're a 40 year old company in a 300 year old industry and innovating every day. Profitably. Check us out. We think you'll like what you find!
EOE StatementWe are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.
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