Claims Examiner

Company Details

As an elite Excess and Surplus Lines market, Nautilus Insurance Group offers commercial property and casualty insurance solutions to appointed wholesale surplus lines producers countrywide. We have specialized in providing these solutions for more than 35 years.

We have more flexible policy terms and premium rates on a non-admitted basis. Our focus is small to medium Property and Casualty risks on both an admitted and a non-admitted basis.

Our offerings are distributed through partnerships with appointed wholesale surplus lines producers. Our relationships are defined by mutual success, speed to market, customer-centric focus and an expanded appetite.

Coverage placed by Nautilus Insurance Group is provided by Nautilus Insurance Company and Great Divide Insurance Company, both W. R. Berkley Corporation members with A.M. Best (Superior) A+ XV ratings.

• Paid Parental Leave! At Nautilus, we offer Childbirth Recovery Leave as well as Primary Caregiver Leave, for up to a maximum of 12 weeks of paid leave.
• Medical, Dental, and Vision coverage options, along with Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) choices.
• 401(k) program, profit sharing, stock purchase plan, life insurance, and travel accident insurance options.
• One of our core values is “Committed to Serve” and we provide every employee one paid day off per year to volunteer at a local charity.
• Tuition Assistance and Industry-Related Education and Exam programs.
• Special cell phone service discounts with Verizon and AT&T.
• Participation in the Plum Benefits program offering cost‑free access to thousands of exclusive travel and entertainment discounts.
• Flexible work arrangements.
• On‑site renovated fitness center – free to use. Yoga and other classes available for a nominal fee.

Nautilus Insurance is seeking a Claims Examiner I or II to join our team. This role can be located in our Scottsdale office or remotely for a highly qualified candidate.

The Claims Examiner I’s primary job function includes efficiently and effectively handling primarily basic, commercial first‑party property and/or third‑party general liability losses in a “paperless” environment. The assigned caseload may include up to one‑half intermediate‑level losses. 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 continues 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 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 a basic and frequently higher 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 in a regular and timely basis Large Loss Reports and other detailed reporting documents as appropriate.
• Manages and monitors file caseload through the use of various resources.
• Obtains all required state adjuster licenses and…