National Interstate Corporation

In 1989, National Interstate Insurance opened its doors with the idea that customer service and personal attention mattered. That clients were more than mere claim numbers, they were people. With real lives and real questions and real needs.We built National Interstate around our customers. And in the process, we built one of the leading specialty property and casualty insurance companies in the country.A wholly-owned subsidiary of National Interstate Corporation (Nasdaq: NATL), National Inte... Read More

Responsibilities

Summary:

Investigate and handle Workers Compensation and PIP/Med Pay claims utilizing state specific guidelines.  The incumbent should develop a fundamental understanding of the claims environment while providing quality customer service.  This includes completing an in-house training program.

Main responsibilities:

    * Initiate the investigation of new claims, make compensability decisions, and evaluate and negotiate settlements of med only, lost time, PIP/Med Pay claims, as appropriate.
    * Manage and oversee the work of outside adjusters, nurse case managers, and experts.
    * Develop a basic understanding of medical principles.
    * Recognize state specific laws and claims regulations throughout the United States to insure proper compliance in claims investigation, including sending and securing proper documentation.
    * Summarize and make recommendations for the disposition of claims in excess of the individual settlement authority.
    * Audit fees of independent adjusters, appraisers, and other vendors in order to properly manage and pay expense invoices.  Consult with the supervisor for guidance on the use of outside experts.
    * Document claim file notes clearly with all communications and activities that occur during the handling of the claim using factual and objective information.
    * Respond to time sensitive materials, including but not limited to hearings and departments of insurance complaints.
    * Manage a diary system to systematically review and resolve claims within the specified state guidelines.
    * Maintain state license(s) by completing continuing education coursework and/or work towards a claims designation.
    * Complete pictorials within the designated timeframe.
    * Other duties as assigned.

 
Qualifications

    * Bachelor's degree required and customer service experience preferred.
    * Claims designation and/or state licensing a plus.
    * Ability to read and interpret insurance policies, state laws and regulations.
    * Ability to speak effectively before vendors, customers, claimants, attorneys, and company management.  
    * Must be able to interpret policies, perform analytical research and investigations, and make sound judgments from data and records collected.
    * May require some work outside of normal business hours to meet deadlines and/or to meet personal performance objectives.

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