National General Insurance

4 job(s) at National General Insurance

National General Insurance Tampa, Florida
01/31/2021
Full time
Primary Purpose: Responsible for handling secondary or transferred claims on high exposure and/or complex losses in which initial work was completed by other claims representative. Review claim for accuracy and completion with regard to investigation into facts of loss, coverage and liability, settlement value, settlement options and plan of action recommended from reassigning party. Assist in training, developing and mentoring of Claim Representatives, along with acting as subject matter expert in the handling of complex and/or legal claim issues. Essential Duties and Responsibilities: Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. Review claims for accuracy and completion with regard to investigation into facts of loss, coverage and liability, settlement value, settlement options and plan of action recommended from reassigning party; determine if additional investigation, medical documentation or work is needed; determine settlement value and settlement options and negotiate injury claims of a serious and complex nature within authority granted Establish liability investigation plan with telephone claims representative on initial losses received; when needed, assist in the investigation by gathering facts and evidence with all witnesses and interested parties, take recorded statements, analyze extent of property damage and review loss reserves, adjusts and/or opens hidden exposures Determine if potential subrogation or fraud issues exist and refer to appropriate claim unit for handling, with recommendation on plan of action, or may independently determine to handle issues to conclusion Gather, analyze and evaluate for settlement purposes all supportive medical documentation which may include obtaining medical authorizations, medical and lost wage records Handle claims in litigation which includes demonstrating knowledge of the litigation process, knowledge of applicable National General litigation policies and procedures and interpreting and applying this knowledge to claims in litigation; determine whether to negotiate settlements directly with plaintiff counsel or refer to defense counsel; manage litigation and recovery costs; utilize ADR when appropriate Assist in training, developing and mentoring of Claim Representatives as needed Act as subject matter expert in regard to complex and/or legal claim handling issues Prepare for and attend legal case mediation and settlement conferences as necessary Assist with file audits, research projects and other assignments as needed Assist management with organizing, facilitating and participating in file roundtables as needed Assume leadership role in the absence of management Required Skills and Competencies: The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Bachelor's Degree or in-lieu of degree equivalent education, training and work-related experience Obtain/Maintain appropriate licensing or education requirements Possess ability to work independently with minimal to no supervision on complex and litigated files Demonstrate strong understanding in file audits to agreed standard of efficient claims quality Demonstrate a solid command of the claims policies and procedures, in addition to, the interpretation of policies and procedures in resolving claims Demonstrate the ability to interpret and apply written coverage accurately to establish claim and determine an action plan Demonstrate a solid understanding of the repair and replacement of property damages, to include mechanical components of a vehicle, homeowner damages and other potential exposures For claims involving injuries, has solid understanding of how to review, evaluate and negotiate injury claims Desired Skills: Possess a thorough command, understanding and knowledge of state laws, regulations and NGI Claims Handling Guidelines applicable to claims handled, including state unfair claim practice laws Demonstrate ability to handle litigation in accordance with company guidelines and be able to recognize legal issues; ability to utilize ADR when appropriate Possess a high degree of initiative, independent judgment and discretion Ability to resolve conflicts and empathize with customers Possess negotiation skills to use in resolving claims Possess professional verbal and written communication skills Possess solid skills in organization and time management Possess expertise in insurance law and able to interpret and apply these laws as it relates to claims Demonstrate a proficient application of the insurance industry and organizational relationships of the company; demonstrate an understanding of the functions of other departments such as Policy Ops and Marketing Possess effective leadership and mentoring skills Successful completion of one or more professional designations: AEI's Legal Principals or completion of the Associate in Claims designation (AIC 33, 34, 35, 36), CPCU, SCLA (Senior Claims Law Associate), FCLS (Fraud), PCLS (Property), CCLS (Casualty), LPCS (Legal Principles) and JD
National General Insurance Winston Salem, North Carolina
01/29/2021
Full time
Primary Purpose: Examine claims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit of authority. Essential Duties and Responsibilities: Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. Establish an investigative plan; initiate investigation by gathering facts and evidence with all interested parties; complete appropriate reports; take recorded statements when necessary, may review loss reserves and adjust or opens hidden exposures as necessary Evaluate and adjust claims within limit of authority and summarize claims in excess of authority and submit to manager for approval Evaluate settlement alternatives by reviewing regulatory compliance and fair claims practices; make decisions on best option Make appropriate contacts to discuss a settlement; extend an offer to appropriate party; document all file activity and payment/settlement information in file notes clearly outlining basis for settlement Determine subrogation or fraud potential and refer to Unit when potential exists or handle to conclusion Identify customer needs and work to meet those needs using appropriate customer service skills Develop an understanding of the functions of other departments, such as Policy Ops and Marketing Trainee Shadow and learn the above stated essential duties and responsibilities Learn to handle most aspects of auto claims Develop a basic understanding of the content of policies written by the company Develop a basic understanding of the insurance industry and the organizational relationships of the company Learn how to determine subrogation or fraud potential and how to handle Develop a basic understanding of systems and technology used within the company Level I Receive claim assignments and verify/investigate coverage and document all appropriate information before Manager is involved with review of claims to ensure they are commensurate with ability May handle more complex files with appropriate supervision to develop skills Develop a working knowledge of systems and technology used within the company Level II Receive claim assignments and verifies/investigates coverage and documents all appropriate information Determine claim approval and or denial up to $7,500 per exposure or $10,000 per file If handling PIP may participate in investigations of medical providers and attend EUOs May work with attorneys in resolving lawsuits Conduct negotiations and settlements within authority level, using independent judgment, or within discretionary levels granted above individual authority level Track and document the quality of service provided by defense counsel and manage litigation and recovery costs May assist in training of Claims Representatives Proficient in using all systems and technology used within the company May be required to make personal appearances on behalf of the company when requested Senior Receive claim assignments and verify/investigate coverage and document all appropriate information with very limited Supervisory involvement May inspect damaged property during an investigation May work with attorneys in resolving serious and complex lawsuits which may mean: conduct negotiations and settlements within authority level, track and document the quality of service provided by defense counsel and manage litigation and recovery costs, and assist manager with research of complex issues and development of defense strategies on litigated files May assist in training and development of other team members or serve as a mentor for others May assist with file reviews and audits Proficient and able to train others in using all systems and technology used within the company May be required to make personal appearances on behalf of the company when requested May also assist manager with preparing reports and completing projects Minimum Skills and Competencies: The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Bachelor's Degree or in-lieu of degree equivalent education, training and work-related experience Successfully completes Claim Representative trainee program, or equivalent external training program Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint) Obtain/Maintain appropriate licensing or educational requirements Demonstrate proficiency in file audits to agreed standard of efficient claims quality High degree of initiative, mature judgment, and discretion Ability to resolve conflicts and empathize with customers is critical Strong negotiation skills Demonstrate professional oral and written communication skills Organization and time management skills are critical for this position Demonstrate an understanding of insurance law as it relates to claims Trainee Learn to recognize and identify all body parts of a vehicle and/or understanding other potential property damage Develop understanding of claim policies & procedures; refers questions to supervisor Develop ability to handle repair/replace decisions Develop labor judgment skills and learn to complete simple estimates accurately Level I Demonstrate the capability of consistently handling aggregate file exposures of at least $2,500 Has a basic command of the claims policies and procedures; exhibit basic interpretation of policies & procedures in resolving claims, but may still need some assistance from supervisor Demonstrate the ability to interpret and apply written coverage accurately to establish claim and determine an action plan, and often requires assistance on more complex files Can handle most types of comprehensive losses (theft, fire, and vandalism), accurately identify total losses Level II Demonstrate the capability of consistently handling aggregate file exposures of at least $2,500 Has a solid command of the claims policies and procedures; exhibit basic interpretation of policies & procedures in resolving claims, but may still need some assistance from supervisor Demonstrate a solid understanding of the repair and replacement of property damages, to include mechanical components of a vehicle, homeowner damages and other potential exposures Senior Demonstrate the capability of consistently handling aggregate file exposures of at least $15,000 Has thorough knowledge of claims policies and procedures in resolving claims and/or providing technical direction to claims representatives Often a source of direction for others on claim policies and procedures Demonstrate the ability to interpret and apply written coverage accurately to establish claim and determine action plan, and rarely requires assistance on complex claims Demonstrate thorough understanding of the repair and replacement of property damages, to include mechanical components of a vehicle, and other potential exposures Demonstrate the ability to find answers to more complex issues with insurance law and may be a source of direction / assistance for other representatives Demonstrates effective leadership and mentoring skills Desired Skills: Demonstrate a thorough understanding of the NGIC Insurance brand and ability to exhibit the behaviors Demonstrate an understanding of the functions of other departments, such as Policy Ops and Marketing Proficient in systems and technology used within the company (i.e. XactContents) #LI-MG1
National General Insurance
01/29/2021
Full time
Primary Purpose: Examine claims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit of authority. Claims involved are usually subject to standardized procedures which lead to a settlement with limited exercise of discretion. Claims involved occasionally require analysis and may require research to resolve coverage and/or damage issues. There is supervisory review of ongoing progress and results of work. There is more focused supervision on all complex files. Essential Duties and Responsibilities: Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. Receive claim assignments and verify/investigate coverage and document all appropriate information before Manager is involved with review of claims to ensure they are commensurate with ability Establish an investigative plan; initiate investigation by gathering facts and evidence with all interested parties; complete appropriate reports; take recorded statements when necessary, may review loss reserves and adjust or opens hidden exposures as necessary Evaluate and adjust claims within limit of authority and summarize claims in excess of authority and submit to manager for approval Evaluate settlement alternatives by reviewing regulatory compliance and fair claims practices; make decisions on best option Make appropriate contacts to discuss a settlement; extend an offer to appropriate party; document all file activity and payment/settlement information in file notes clearly outlining basis for settlement Determine subrogation or fraud potential and refer to Unit when potential exists or handle to conclusion May handle more complex files with appropriate supervision to develop skills Develop a working knowledge of systems and technology used within the company Identify customer needs and work to meet those needs using appropriate customer service skills Required Skills and Competencies: The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Bachelor's Degree or in-lieu of degree equivalent education, training and work-related experience Successfully completes Claim Representative trainee program, or equivalent external training program Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint) Obtain/Maintain appropriate licensing or educational requirements Demonstrate the capability of consistently handling aggregate file exposures of at least $2,500 Demonstrate proficiency in file audits to agreed standard of efficient claims quality Has a basic command of the claims policies and procedures; exhibit basic interpretation of policies & procedures in resolving claims, but may still need some assistance from supervisor Demonstrate the ability to interpret and apply written coverage accurately to establish claim and determine an action plan, and often requires assistance on more complex files For claims involving material damage, comply with the company material damage guidelines Can handle most types of comprehensive losses (theft, fire, and vandalism), accurately identify total losses For claims involving injuries, have a general understanding of how to review, evaluate, and negotiate injury claims High degree of initiative, mature judgment, and discretion Ability to resolve conflicts and empathize with customers is critical Strong negotiation skills Demonstrate professional oral and written communication skills Organization and time management skills are critical for this position Demonstrate an understanding of insurance law as it relates to claims Demonstrated proficiency with basic computer skills with word processing, spreadsheets, email and internet Desired Skills: Demonstrate a thorough understanding of the NGIC Insurance brand and ability to exhibit the behaviors Demonstrate an understanding of the functions of other departments, such as Policy Ops and Marketing
National General Insurance Atlanta, Georgia
01/25/2021
Full time
Job Description Primary Purpose: Manage a team of BA's (business analysts) who are responsible for the analysis of new business system development and improvement of existing business processes. Lead team of BA's toward the goal of maximizing business value delivery through application development. Partner with senior business and IT leadership to assist in the prioritization of projects for assigned division. Essential Duties and Responsibilities: Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time. Manage a team of business analysts to contribute to continuous business process improvement initiatives by assessing effectiveness of current processes to recognize opportunities for increased efficiency, cost reduction, increased quality and improved end user experience Engage team to work with the business to identify potential solutions, provide recommendations and lead team to define the strategic requirements to achieve the business goals efficiently Lead Business Analysts (agile and waterfall), with the goal of clearly communicating Business objectives and maximizing business value creation through IT execution Communicate both written and verbal with senior business partners to provide updates on project statuses and answers questions on related BA project work Support other managers by taking on additional responsibilities for discrete work teams Allocate team resources and monitor deliverables to ensure the end user needs are met successfully and in a timely fashion Drive Business Analysts to deliver clear and concise requirements for continuous improvement to maximize value delivered to the business and to eliminate rework and reduce defects Coordinate with other teams to identify and implement new systems to support business function at effective cost Manage staff in the day-to-day performance of their jobs Ensure that project/department milestones/goals are met and adhering to approved budgets Maintain extensive knowledge of department processes Leverage key metrics to evaluate if projects delivered have met desired outcome through analysis of existing issue, problem solve expeditiously, ensure timely delivery of requirements to meet or exceed desired timelines Minimum Skills and Competencies: The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Bachelor Degree or in-lieu of degree equivalent education, training and work-related experience 5+ years of relevant experience 3+ years of people management experience or as lead BA Excellent interpersonal skills with the ability to establish working relationships with individuals at varying levels within the organization Established track record of delivering business value through desired project outcomes based on well documented requirements Ability to rely on extensive experience and judgment to plan and accomplish goals Ability to share knowledge and provide subject matter expertise within area of responsibility Able to work in a dynamic environment and manage competing priorities Analytical skills with the ability to organize tasks and interact with development team Effective organization and time management skills with the ability to work under pressure and adhere to project deadlines Business and management principles involved in strategic planning, resource allocation, leadership technique, and coordination of people and resources Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint) Desired Skills: Master's Degree or in-lieu of degree equivalent education, training and work-related experience 3+ years of experience working directly with IT application development 3+ years of experience working with a relevant business division with experience in strategic planning and execution Previous experience in Insurance or Financial related industries #LI-CM1 #LI-Remote