EMC Insurance Companies

Administration

• Analyzes and investigates claims to ensure compliance and timely payment of benefits
• Responds to agents and policyholders regarding pending claims and appeals
• Processes complex beneficiary and ownership changes and approves eligibility of waivers for life and disability income policies
• Collaborates with peers and management to ensure consistent interpretations of policies and claim payment methods
• Obtains reports, medical records, eligibility, and/or additional information required to investigate and process claims
• Prepares filings for all life reinsurance benefits and tracks status of payments
• Ensures that claims are in compliance with state and federal mandates and reviews for red flags associated with potentially fraudulent claims
• Trains new claims team members and assists current claims staff with processing issues
• Documents claims procedures and maintains the claims administration manual as assigned by the Claims Manager

Senior Claims Administrator

Consultant

• Leads end to end delivery of complex and/or enterprise-wide innovation initiatives
• Oversees the entire process from initial intake and scoping through to delivery and integration back into the core business
• Designs and facilitates innovation workshops and sessions, using design thinking and other creative methodologies to engage internal partners and stakeholders
• Provides high level consultative services to internal and external partners regarding innovative processes and ideas
• Collaborates with business units and external partners to identify challenges, gather requirements, and co-create innovative solutions
• Drives continuous improvement by capturing lessons learned, iterating on processes, and sharing best practices
• Supports the development of innovation capabilities across the organization via projects lead within other business units
• Defines and tracks success metrics—including learning milestones, early wins, ROI, and business unit satisfaction

Senior Business Innovation Consultant

Underwriter

• Prepares and approves renewals for accounts within authority limit with a focus on long term profitability, retention and achieving branch and company pricing goals
• Based on branch established guidelines, leverages negotiation skills to obtain adequate rate
• Reviews account information, including coverage details, claims history, and any relevant updates or changes
• Evaluates the risk profile of each account and assesses its eligibility for renewal based on established underwriting guidelines
• For accounts outside authority, prepares information for underwriter to complete the renewal
• Communicates with agents to ensure all renewal information has been requested and received
• Regularly collaborates with underwriters throughout the renewal process ensuring a holistic approach to managing the agency book of business
• Maintains proper file documentation
• Develops relationships with agents by providing excellent customer service to promote renewal retention
• Builds and nurtures relationships with agents by regularly engaging in meaningful interactions, such as face-to-face meetings, virtual meetings, phone conversations, and written communication
• Responds to concerns or issues raised by agents regarding endorsements and renewals promptly and effectively, collaborating with internal teams to find solutions that meet the needs of both the carrier and agency
• Reviews and approves endorsements that fall within a specified list of requirements and within authority
• Underwrites and provides endorsement quotes to agents
• Corresponds with agents for additional information
• Assesses the potential risks associated with proposed endorsements, taking into account factors such as policy coverage, loss history and claims data to evaluate the overall impact on the policy
• Determines if additional information or assessments are required for accurate decision-making
• Reviews and approves reinstatements and cancellations
• Assists agents with policy billing inquiries
• Performs support duties for branch departments including but not limited to, ordering and analyzing reports as appropriate, reviewing drivers, and completing monthly projects
• Collaborates with experienced underwriters and territory management team members to develop understanding of company and branch risk appetite, underwriting resources, and systems

Underwriting Associate

IT Support

• Serves as first point of contact for users seeking assistance with underwriting management, policy administration and rating platforms
• Researches and answers inquiries, including moderately complex inquiries, from all levels of underwriting and rating team members as they related to general operation of the underwriting and policy systems, business procedures, system speed, outages and system documentation
• Assists front line users/departments in their completion of policy transactions by analyzing the error, reviewing the detailed policy information, formulating a response on how to address the issue
• Assists and performs troubleshooting through diagnostic techniques and pertinent questions
• Creates and updates online help documents for underwriting management and policy systems as assigned
• Assists in User Acceptance Testing (UAT) for assigned systems and features
• Reviews the screen documentation to ensure that it matches the production screen functionality
• Records, monitors, and reports on the progress of application changes and enhancements requests as a result of a help desk inquiry

Underwriting Management, Policy Help Desk Specialist

• Collaborates with people leader to execute company underwriting framework within assigned industry segment
• Creates and communicates best practices and underwriting guidance to the company
• Serves as a technical expert in Corporate Underwriting on responses to questions on assigned business segment
• Analyzes premium and loss data and other key reports on monthly and quarterly basis to ensure long-term profitable growth
• Communicates and makes recommendations for improvement needed to meet company goals and improve underwriting results
• Recommends and develops new product ideas, reviews existing products, and assists with drafting new coverage language
• Participates in on-going collaboration with risk improvement, claims, actuary and other appropriate teams in support of enterprise wise business and profitability goals
• Provides direction, training, and guidance for less experienced team members as appropriate

Industry Segment Consultant – Retail & Services

Compliance

• Manages a team responsible for accurate and timely reporting to regulatory authorities and reporting bureaus.
• Leads the analysis of regulatory texts, official guidance documents, regulatory updates, and industry publications to understand the nuances of reporting requirements.
• Maintains a deep understanding of the regulations and reporting requirements impacting assigned lines of business.
• Collaborates closely with Compliance, legal counsel, and regulatory affairs teams to ensure a comprehensive understanding of regulatory requirements.
• Oversees risk assessments and impact analyses to evaluate the potential effects of regulatory changes on reporting processes, systems, controls, and business operations.
• Identifies gaps and implements mitigating measures to effectively address regulatory compliance challenges.
• Manages the creation of detailed documentation of regulatory interpretations, reporting methodologies, data sources, and compliance activities for audit purposes and regulatory examinations.
• Communicates with states and reporting bureaus as required to manage expectations, answer questions, and ensure compliance with requirements.
• Manages and triages incoming requests according to requirements, priority, and due dates; assigns work to team members and monitors team deliverables to ensure timely and accurate completion.
• Works cross-functionally with various departments including Claims, Underwriting, Finance, and Information Technology to identify, acquire, and report information.
• Utilizes analytical capabilities to conduct root cause analysis and to investigate compliance issues, identify systemic weaknesses, and implement corrective actions to ensure accurate and timely reporting.
• Serves as an escalation point for issues impeding team progress and acts as liaison across departments to manage work dependencies.
• Evaluates team workflows for efficiency and effectiveness, creates process documentation and workflow maps, identifies bottlenecks, and implements process improvements to enhance productivity and quality.
• Develops team metrics and KPIs to monitor ongoing performance, inform decision making, and communicate priorities to team members and stakeholders.
• Builds culture and develops team members while overseeing regulatory and bureau reporting functions.
• Develops training materials, conducts workshops, and organizes knowledge-sharing sessions to facilitate continuous learning and skills development.
• Collaborates with team members to establish performance goals and monitors status, conducts performance reviews, and provides coaching.
• Interviews, hires, and recommends salary adjustments for team members.
• Resolves disciplinary issues, reviews results, action plans, and progress.
• Develops team expertise and completes succession planning, including identifying talent and implementing development plans for critical positions.
• Supports diversity, equity, and inclusion initiatives.
• Fosters an innovative culture, including supporting new ideas and providing guidance on potential changes.
• Leads selection, onboarding, and ongoing management activities for vendor solutions handling data and report submissions to bureaus or states.
• Researches and evaluates potential vendors, conducts due diligence including formal assessments, prepares business cases, and negotiates contracts.
• Collaborates with vendors to integrate the company’s systems and processes, providing oversight of data mapping, issue resolution, and deliverable acceptance.
• Oversees periodic reviews and audits of vendor solutions to ensure the accuracy and integrity of data submissions.
• Manages vendor contracts including renewal negotiations, amendments, and terminations as needed.
• Manages the development and maintenance of internal and external data extraction, transformation, and load routines from diverse sources into target systems and files.
• Oversees the creation of data cleansing routines to ensure data quality and consistency across different sources.
• Manages the creation of reusable business rules, validation checks, and error handling mechanisms necessary for reporting purposes.
• Evaluates and leverages different data extraction tools such as SQL, VBA, Denodo, and Excel to prepare and deliver data; manages diverse data sources, integrates data, and oversees data reporting processes.
• Oversees the creation of data maps and specifications for internal and external stakeholders in support of regulatory requirements.
• Identifies opportunities to optimize data integration routines, SQL queries, and data processing workflows to improve performance and efficiency.
• Oversees data quality standards with each industry bureau to ensure EMC receives the correct reporting credits for accuracy and timeliness of reporting.
• Oversees and manages the performance of the team through Agile ceremonies and traditional project management methodologies to coordinate team projects effectively, foster collaboration, and ensure project objectives are met within scope, budget, and timeline.
• Liaises with Digital Product Management teams as necessary to integrate regulatory reporting requirements into product backlogs.
• Manages cross-functional team dependencies, risks and issues, and prioritization processes to ensure team deliverables are met.
• Collaborates with the Statistical Data Management Product Owner to inform and manage scope and priorities.
• Establishes regular communication channels with stakeholders to provide project updates, solicit feedback, and address concerns or issues in a timely manner.
• Directs the creation and maintenance of documentation in OneSumX and Jira as required.

Statistical Compliance Manager

Sales

• Join EMC as Vice President of Sales & Distribution Management and lead the strategy that fuels our growth—advancing our sales culture, strengthening key agency relationships, and delivering sustained, profitable performance across our business
• Sets and communicates the strategic vision for SDM and EMC’s Sales culture, in alignment with EMC’s mission, values, brand and long-term business strategy
• Develops, drives and measures a cohesive go-to-market strategy for EMC’s four business units, in close partnership with UW, Marketing and Field leadership
• Develops, drives and measures execution of the sales playbook and key performance criteria for premium growth and distribution optimization
• Establishes and monitors key performance indicators (KPIs) for all functional areas within SDM and Field Sales and holds people accountable for achieving results
• Serves as a key leader in Officer decision-making forums and at the executive level, for enterprise-wide and major transformation initiatives, and innovation projects, contributing to company-wide strategy, resource allocation, and policy development
• Leads strategy and engagement for EMC’s most critical (KDP) agency relationships
• Develops, drives and measures execution of EMC’s KDP strategy in close collaboration with Underwriting, Marketing and Field leadership
• Cultivates and maintains strategic, two-way, value-driven relationships with key agency partners, industry associations, and external stakeholders
• Anticipates and promptly communicates independent agent trends, market shifts, and competitive dynamics; proactively adjusts departmental strategies to maintain EMC’s leadership position.
• Responsible for identification, development and execution of short- and long-term SDM and Field Operations data and reporting needs and solutions
• Leads SDM in supporting and providing Sales and other business insights for technology and data transformation initiatives, including DAP, ADM, CRM, and product enhancements
• Partners with FP&A, project business partners, Compliance, and Internal audit to ensure appropriate controls are in place for relevant data protection regulations and industry standards
• In close partnership with FP&A, Legal, Compliance, Underwriting and the Field, oversees the design, implementation, and maintenance of competitive agency distribution compensation and incentive plans, including all agency compensation contracts and agreements, and regular analysis of compensation expense levels

Vice President – Sales & Distribution Management

Claims Specialist

• Independently investigates, evaluates, negotiates, and resolves workers’ compensation claims within authority guidelines; communicates with insureds, agents, and partners on coverage, status, and inquiries
• Investigates and evaluates claims, verifying coverage, jurisdiction, and compensability
• Initiates timely contact with insureds, claimants, and relevant parties to explain the claims process
• Gathers statements, documentation, and official reports; documents all file activity and updates claim records
• Sets and adjusts reserves in line with company guidelines
• Reviews medical treatment, billing, and wage data to determine appropriate benefits and payments
• Coordinates medical care and return-to-work efforts
• Identifies and pursues subrogation and recovery opportunities
• Ensures timely statutory notifications and compliance with jurisdictional requirements
• Monitors claim progress and escalates complex claims as needed
• Prepares settlement evaluations, strategies, and negotiation targets
• Investigates and resolves compensability and coverage issues
• Negotiates settlements and collaborates with attorneys; attends mediations and conferences as needed
• Issues settlement documentation and payments within authority limits
• Provides clear, timely claim status updates to insureds, agents, and claimants
• Ensures compliance with all state reporting and documentation requirements
• Collaborates with internal teams (SIU, Subrogation, Medical, etc.) and supports team members
• Submits referrals and promotes programs such as return-to-work and preferred provider networks
• Assists with account servicing and marketing efforts as needed
• Maintains licenses/CEUs and completes ongoing training on regulatory and medical updates

Workers' Compensation Claims Adjuster I

Client Services Representative

• Serves as the point of contact for assigned EMC Claims Solution’s (ECS) clients, ensuring proactive, consistent high quality service experiences
• Investigates service issues and discrepancies to ensure all relationship needs are met
• Partners with appropriate internal teams to resolve client concerns and ensure overall alignment
• Performs root cause identification and implementation of solutions to enhance satisfaction and retention
• Prepares assigned materials to participate in client meetings, stewardship reviews, and training sessions
• Performs client calls and/or meetings to provide excellent client services practices
• Provides responses to client inquiries and gathers claims data, prepares reports, and organizes information
• Participates in the identification of communication gaps or training needs
• Delivers identified training as assigned
• Collaborates with people leader to prepare presentations, proposals, and marketing materials
• Develops assigned newsletters, blogs, and client communications
• Maintains contract lists, databases, and marketing files
• Conducts research on industry trends, competitors, and target markets
• Identifies opportunities to streamline workflows and improve efficiency, and implements approved changes
• Coordinates vendor expectations and resolves minor vendor issues
• Partners with people leader on conference preparation and follow up
• Works with leader to develop action items and opportunities from conference findings and relationships

Business Development Rep

• Oversees assigned territory, building and maintaining relationships with agent and broker partners driving profitable revenue growth
• Creates, implements and executes territory and agent/broker strategies
• Owns the business development process within assigned market area
• Represents EMC Claims Solutions at sales, claims, and insurance conferences and events
• Maintains a tracking document for the stage and ownership of each item within an RFP
• Researches EMC’s competitive position in the marketplace
• Builds and cultivates complex agent/broker partnerships
• Creates tactical sales plans that provide for the profitable growth of targeted business segments
• Regularly monitors and modifies agent/broker plans according to their performance data
• Leads RFP processes for identified potential clients
• Develops proposals demonstrating EMC Claims Solution’s value and abilities to attract and sign clients
• Collaborates with Claims Solutions leadership to build custom proposals
• Manages all external-facing marketing materials

Claims Solutions Business Development Consultant

• Independently investigates, evaluates, negotiates, and resolves large and moderately complex to complex commercial property and reinsured cyber claims, including litigated matters, within assigned authority
• Analyzes coverage, cause of loss, scope, valuation, and business income exposure; establishes timely and adequate reserves
• Conducts field inspections and oversees re-inspections, including participation in catastrophe operations
• Coordinates and manages experts and vendors (e.g., engineers, remediation firms, contractors, origin and cause specialists) to address urgent claim needs and preserve evidence
• Communicates claim status, coverage positions, and resolution strategies with insureds, agents, attorneys, and internal partners
• Develops negotiation strategies, evaluates settlement ranges, and negotiates claim settlements in accordance with company guidelines
• Drafts and issues reservation of rights, denial letters, settlements, proofs of loss, and payments with accuracy and compliance
• Manages litigated claims, recommends defense counsel, and collaborates with attorneys through mediation, appraisal, arbitration, or trial
• Identifies recovery, subrogation, and potential fraud opportunities; partners with SIU as appropriate
• Reviews and audits estimates and invoices for accuracy, reasonableness, and cost-effective repair solutions
• Collaborates with Underwriting, Risk Improvement, and other specialty units to support risk evaluation and account management
• Serves as a technical resource and mentor to less experienced adjusters and participates in cross-functional initiatives

Senior Property Claims Adjuster

• Investigates and evaluates medium-sized and moderately complex commercial property and reinsured cyber claims
• Conducts field inspections as needed and coordinates internal and external experts to manage mitigation, temporary restoration, business continuity, evidence preservation, and cause-and-origin analysis
• Initiates timely contact with insureds, claimants, and other parties to explain the claims process and meet legal notice requirements
• Obtains statements from insureds, claimants, witnesses, and other relevant parties and secures all required claim forms and documentation
• Reviews estimates, invoices, receipts, and financial records to assess property damage and business income loss
• Documents claim activity, summaries, and reserve analyses in the claim system and establishes timely, accurate reserves in accordance with company methodology
• Escalates claims exceeding authority to the Claims Supervisor for review or reassignment
• Resolves issues related to coverage, causation, valuation, and repair methodology and communicates claim status with insureds, claimants, agents, and attorneys
• Prepares and reviews repair estimates using research and estimating software, addressing discrepancies as identified
• Negotiates and settles claims within assigned authority and recommends settlements to management when outside authority
• Drafts and issues reservation of rights and denial letters with approval and prepares settlement documents, statements of loss, proof of loss, and timely payments in compliance with requirements
• Identifies and pursues recovery opportunities, including subrogation and legally compliant evidence preservation
• Identifies potential fraud and refers claims to the Special Investigations Unit (SIU) when appropriate
• Supports mediations, appraisals, arbitrations, and litigation preparation as needed
• Prepares risk reports and participates in coverage, account, and inspection reviews with Underwriting and Risk Improvement
• Audits estimates prepared by independent adjusters and contractors to ensure accuracy and cost-effective repairs
• Handles referred claims from other departments, supports team members, participates in claims roundtables, and contributes to projects as needed