Key Facts

Remote From:

Canada , California (USA) , United States

Full time

Expert & Leadership (>10 years)

English

Hard Skills

Other Skills

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Computer Literacy
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Decision Making
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Professionalism
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Non-Verbal Communication
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Client Confidentiality
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Negotiation
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Teamwork
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Telephone Skills
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Critical Thinking
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Decisiveness
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Customer Service
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Detail Oriented

Roles & Responsibilities

10+ years of progressive claims handling experience (carrier experience preferred).
Four-year college degree or equivalent business experience.
Ability and willingness to obtain adjuster licenses in various states.
Expertise in one or more standard casualty lines or Property claims with strong knowledge of tort law, policy and contracts and excellent communication/negotiation skills.

Requirements:

Determines coverage applicable to loss and investigates, manages and resolves claims in a timely, unbiased manner in compliance with company policies, state laws and regulatory standards.
Sets and maintains adequate claim reserves, determines liability, and evaluates and pays claims within designated authority; prepares status reports for management and reinsurers as required.
Manages legal aspects by assigning defense counsel, monitoring litigation, coordinating with insureds and outside counsel, and reporting on defense costs and outcomes.
Communicates with external and internal customers, participates in audits, department/claims committee meetings, and supports team approach and training initiatives.

Nonprofits Insurance Alliance (NIA)

Insurance

About Nonprofits Insurance Alliance (NIA)

Nonprofits Insurance Alliance (NIA) is the nation’s leading property and liability insurer exclusively serving nonprofit organizations. Founded in 1989 in Santa Cruz, CA, NIA is a social enterprise developing the long-term sustainability of the nonprofit sector. NIA has one of the best customer retention rates in the industry. NIA members enjoy fair and equitably-priced insurance, specialized insurance coverage, dividends, and innovative risk management and member services. Our coverages include: Commercial General Liability, Directors and Officers (D&O), Flat Rate D&O, Improper Sexual Conduct, Social Service Professional, Employee Benefits Liability, Business Auto, Non-Owned/Hired Auto, Umbrella Liability, Auto Physical Damage, Employee Dishonesty, Commercial Property, and Participant/Volunteer Accident. Nonprofits Insurance Alliance is the tradename for a group of insurers — NIAC, ANI, and NANI — all of whom are public-benefit 501(c)(3) nonprofits and rated A (Excellent) by AM Best. All NIA organizations are administered by Alliance Member Services (AMS), also a 501(c)(3) nonprofit. Today, more than 25,000 nonprofit organizations in 32 states and the District of Columbia rely on NIA for liability insurance coverage. These include children’s programs, group homes, senior organizations, art programs, food banks, community groups, foster family agencies, and many others. These mission-driven organizations are essential to the health of the communities they serve and it is NIA's mission to help keep the nonprofit sector strong.

Company type: SME

Industry: Insurance

Founded: 2018

Company size: 51 - 200

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Job description

Who We Are

Nonprofits Insurance Alliance (NIA) is the nation’s leading property and casualty (P&C) insurer exclusively serving nonprofit organizations. Founded in 1989 in Santa Cruz, CA, all of the companies in NIA are 501(c)(3) nonprofits-- social enterprises providing long-term sustainability of the nonprofit sector. NIA has one of the best customer retention rates in the industry and has a well-established track record as an innovator in the areas of corporate social responsibility (CSR), specialized coverages, members services, and employee engagement.  

Summary

Reporting to the Claims Manager and working independently and with great latitude for independent action, this position manages an inventory consisting primarily of claims with higher loss potential and complexity, and commensurate reserving, settlement authority, reinsurance reporting requirements, as well as claims of lesser exposure or severity as dictated by the needs of the department. Investigates, evaluates and settles claims within designated authority. Occasionally assigns and directs Independent Adjusters/Appraisers and regularly assigns and directs defense attorneys.

The ideal candidate would have 10+ years carrier experience and be capable of working independently as well as collaboratively and have prior experience working remotely from a home office. In this position, thorough knowledge and experience is assumed for one or more standard casualty lines, or for demonstrated experience in Property claims.

Responsibilities

The Claims Examiner IV responsibilities include but are not limited to:

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

Required Competencies

Requires highly technical claim management skills, and significant knowledge of and experience with more than one of the following: Employment Practices Liability, Social Service Professional, Sexual Abuse, General Liability, and/ or Automobile or demonstrates expertise in Property claims management as stand alone expertise in the Property area.
Ability and willingness to obtain adjuster licenses as needed in various states.
The incumbent will demonstrate a 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).

Must demonstrate good written and oral communication skills.
Must be organized and possess strong follow-up skills.
Requires the 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 are essential.
Possesses and regularly demonstrates 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
Incumbent must be aware of and follow guidelines concerning confidentiality.
The position communicates with legal and medical personnel, third party claimants, policyholders, producers, Reinsurers, and senior level staff throughout the company.
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
Collaborate with other staff members and external partners
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 if needed) to clearly view computer screen
Must have adequate hearing to perform job tasks
PC literacy required; proficiency in Windows, Word, and Outlook preferred.
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.
Must have adequate hearing to perform job tasks
If performing as a Property specialist, will be adept at large loss handling techniques, including catastrophe claims.

Experience

• The position generally requires a minimum of ten or more years of progressively more difficult claims handling experience.

Education

• Four year college degree or equivalent business experience.

Compensation: The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors including the location, skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for additional incentive compensation upon achievement of individual and company goals.

Salary Range

$80,000 - $130,000