Sr. Claims Examiner

Senior Claims Examiner

Nautilus Insurance is seeking a Senior Claims Examiner. This role can be located in our Scottsdale office on a hybrid schedule or remotely for a highly qualified candidate.

The Senior Claims Examiner's primary job function includes efficiently and effectively handling intermediate-level, commercial first-party property and / or third-party general liability losses in a "paperless" environment. 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 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.
• 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 an intermediate 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 Large Loss Reports and other detailed reporting documents as appropriate in a regular and timely basis.
• Manages and monitors file caseload through the use of various resources.
• Obtains all required state adjuster licenses and maintains them as required via compliance with mandatory continuing education requirements.
• Serves as a technical resource within the Department through mentoring and knowledge-sharing, whether one-on-one, in small groups, or presentations to larger groups.
• Meets with intern personnel and others as needed to provide job function overview and / or specific subject-matter training.
• Occasionally participates 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 provides feedback to peers and / or members of management.
• Other duties may be assigned.

Qualifications