Next Insurance

• Investigate, evaluate, and resolve General Liability Bodily Injury, Property Damage, as well as Professional Liability claims, both with and without attorney involvement. • Analyze coverage, liability, and damages based on policy terms, claim reports, statutes, and case law to determine appropriate claim handling. • Communicate effectively with policyholders, claimants, and witnesses to gather information, provide updates, and guide the claims process. • Identify and refer potentially fraudulent claims to SIU and pursue third-party subrogation opportunities where applicable. • Ensure compliance with all relevant statutory and regulatory requirements across jurisdictions. • Demonstrate strong customer service skills with empathy, clear communication, and a focus on resolution.

• Use your claims-handling expertise to enable great outcomes on complex and litigated claim files through leading independent contributors, direct managers and consulting on high-stakes claim roundtables. Balance multiple roles and responsibilities with leading other Claims Leaders. • Effectively manage multiple departmental relationships across a highly matrixed organization within a large, international insurance group. • Partner with critical team members and cross-functional business partners (Product, Legal, Actuarial, Engineering, Information Systems) to effectively utilize and improve existing litigation data and insights. • Work with internal team members and cross-functional partners in our Data Science group to source litigation data delivery to the Claim’s Org for a variety of use cases. • Manage vendor portfolio for third-party legal service related vendors. Build effective relationships, drive exceptional outcomes, and deliver against cost goals in this space. • Work closely with internal Compliance, Legal, and Risk Management teams to enable consistent execution against everything from SOX controls to third-party audit execution on behalf of major capital providers. Complete monthly litigation file audits to help uplevel our collective litigation claim work product through effective evaluation. • Coordinate critical communication on complex and litigated claims to all key stakeholders, both internal and external.

• Extensive policy document and legal contract interpretation • Ability to analyze and identify coverage and related coverage issues • Leverage a working knowledge of insurance contracts, Unfair Claims Settlement Practices, insurance codes, civil codes, vehicle codes, arbitration rules and regulations, tort law, claims best practices handling and management as part of your ongoing adjudication of claims • Manage, investigate, and resolve claims within prescribed authority levels • Recommend ultimate resolution on assigned cases in excess of authority to claims management • Rely on a deep background of litigation handling experience in both General Liability and Casualty files to resolve claims • Consistently drive litigation, attend mediations, trials, and other alternative dispute resolution avenues • Communicate with policyholders, witnesses, and claimants in order to gather information regarding claims, refer tasks to auxiliary resources as necessary, and advise as to the proper course of action • Preemptively communicate and respond to various written (email, SMS, fax, mail) and telephone inquiries, including status reports • Present file materials for authority and roundtables • Work with nurses, doctors, and attorneys on file reviews • Comply with all statutory and regulatory requirements of all applicable jurisdiction • Meet detailed quality assurance standards and meet set goals for performance • Set and revise case reserves in accordance with the reserving policy • Identify potentially suspicious claims and refer to SIU; identify opportunities for third-party subrogation • Be accountable for the security of the financial processing of claims, as well as security information contained in claims files • Work with, and provide claim-specific guidance to, independent field adjusters • Partner closely with internal teams and advise leadership of key claim activities and exposures

• Handle complex cases involving true Bad Faith claims with adverse and identified coverage/claims handling issues. • Manage documented cases of daycare abuse/molestation, ensuring thorough investigation and resolution. • Handle fatality cases with coverage issues, providing expert analysis and resolution. • Manage construction defect cases, specifically focusing on complex ones involving multiple parties and intricate contractual issues. • Centralize Declaratory Relief Actions by taking charge of coverage files and coordinating with relevant parties. • Handle severe injury cases with complex issues, including coverage, liability, or damages concerns. • Evaluate policy limit exposures, ensuring a true policy limit exposure exists and the potential for extra-contractual exposure is real. • Address problematic claims that require dedicated attention to achieve resolution.

AI Underwriting Data Manager Boston, MA Location: Waltham, MA (hybrid) ERGO NEXT's mission is to help entrepreneurs thrive. We’re doing that by building the only technology-led, full-stack provider of small business insurance in the industry, taking on the entire value chain and transforming the customer experience. Simply put, wherever you find small businesses, you’ll find ERGO NEXT. Since 2016, we’ve helped hundreds of thousands of small business customers across the United States get fast, customized and affordable coverage. We’re backed by industry leaders in insurance and tech, and we still have room to grow — that’s where you come in. Seize the opportunity to be a part of an exciting transition in the insurance industry! We're inviting an accomplished and forward-thinking data manager to join our AI Underwriting team. This pivotal role will have you innovating and developing groundbreaking digital underwriting features in partnership with our insurance, data, engineering, and machine learning teams. What You'll Do: - Manage a team of analysts, including training and guidance, establishing clear goals and responsibilities, and ongoing performance management - Manage the overall budget for underwriting third-party data. - Deliver substantial savings by identifying efficiencies and ways to in-house data services. - Own and drive the product roadmap for data integrations. - Serve as the key business connection for external data vendors. - Partner with the procurement team on vendor contract negotiations. - Collaborate with internal stakeholders to identify and onboard new external data vendors. - Manage the Proof of Concept process for testing and evaluating new data vendors. - Create detailed product requirements for services that leverage data integrations. - Define success criteria for Proofs of Concept and evaluate results in partnership with underwriting. - Prioritize PoCs and provide regular reporting on progress and outcomes to senior leadership. - Oversee vendor performance metrics and usage reporting, using results to inform strategic decisions. - Escalate critical vendor issues and maintain high-level relationships with vendor leadership. What We Need: - Budget Oversight: Proven experience in managing and tracking a data budget, including forecasting, monitoring monthly expenditures, and identifying areas to optimize spending. - Vendor Negotiation: Strong negotiation skills to secure favorable terms with data vendors, ensuring cost-effective solutions that meet business needs. - Relationship Management: Ability to build and maintain strong relationships with external data vendors, ensuring smooth collaboration and service delivery. - API Proficiency: Proficient in using API clients such as Postman to test, run, and troubleshoot API services. - Technical Documentation: Ability to read, understand, and apply API documentation for integration purposes. - Service Evaluation: Capability to assess new data services, including running Proof of Concepts (PoCs) to determine their fit for the company’s needs. - Roadmap Development: Experience in developing and maintaining a roadmap for data integrations, aligning with the company’s strategic goals and underwriting needs. - Executive Communication: Strong presentation skills to effectively communicate the integration roadmap and progress to executives and other senior stakeholders. - Cross-Functional Collaboration: Ability to work closely with internal stakeholders, including product, engineering, and underwriting teams, to ensure successful implementation of the roadmap. - Data Analysis: Ability to interpret vendor data using SQL or Python to validate performance and support strategic decisions. Note on Fraudulent Recruiting We have become aware that there may be fraudulent recruiting attempts being made by people posing as representatives of ERGO NEXT Insurance. These scams may involve fake job postings, unsolicited emails, or messages claiming to be from our recruiters or hiring managers. Please note, we do not ask for sensitive information via chat, text, or social media, and any email communications will come from the domain @next-insurance.com or @nextinsurance.com. Additionally, Next Insurance will never ask for payment, fees, or purchases to be made by a job applicant. All applicants are encouraged to apply directly to our open jobs via the careers page on our website. Interviews are generally conducted via Zoom video conference unless the candidate requests other accommodations. If you believe that you have been the target of an interview/offer scam by someone posing as a representative of Next Insurance, please do not provide any personal or financial information. You can find additional information about this type of scam and report any fraudulent employment offers via the Federal Trade Commission's website (https://consumer.ftc.gov/articles/job-scams), or you can contact your local law enforcement agency. The range displayed on this job posting reflects the minimum and maximum target for new hire base salaries for the position in the location(s) listed. Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education or training. ERGO NEXT employees are also potentially eligible for our annual performance-based incentive program, in addition to our benefits package, consisting of our partially subsidized medical plan, fully subsidized vision/dental options, life insurance, disability insurance, 401(k), flexible paid time off, parental leave and more. US annual base salary range for this full-time position: $152,000 - $179,000 USD Don’t meet every single requirement? Studies have shown that some underrepresented people are less likely to apply to jobs unless they meet every single qualification. At ERGO NEXT, we are dedicated to building a diverse, inclusive and respectful workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles. One of our core values is 'Play as a Team'; this means making sure everyone has an equal chance to participate and make a difference. We win by playing together. ERGO Next Insurance is an equal opportunity employer and prioritizes building a diverse and inclusive workplace. We provide equal employment opportunities to all employees and applicants of any type and do not discriminate based on race, color, religion, national origin, gender, age, sexual orientation, physical or mental disability, genetic information or characteristic, gender identity and expression, veteran status, or other non-job-related characteristics or other prohibited grounds specified in applicable federal, state, and local laws. ERGO Next's policy is to comply with all applicable laws related to nondiscrimination and equal opportunity and will not tolerate discrimination or harassment based on any of these characteristics. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

• Own the full premium audit lifecycle for WC and GL lines of business, managing pipelines, backlogs, and reconciliation workflows, while ensuring strict adherence to NCCI, WCIRB, and other state-specific regulatory requirements • Lead, coach, and develop a high-performing organization of managers and QA staff • Spearhead a comprehensive QA program to ensure accuracy in payroll and class codes, utilizing trend analysis to identify systemic errors and lead corrective initiatives • Manage external audit vendors by optimizing assignment strategies and performance standards; partner with Finance on spend analysis, budgeting, and cost-optimization across internal and vendor partners • Continuously enhance the audit customer journey to reduce friction, improve clarity, and increase audit completion rates • Serve as the operational lead for audit system automation, partnering with Engineering, Product, Reporting, and Data Science to define requirements, conduct testing, and deploy AI-centric audit tools and features • Refine and deliver weekly, monthly, and quarterly reporting on production, quality trends, and organizational performance • Act as the owner for state inquiries and internal partners (Underwriting, Reporting, Claims, Compliance) to resolve regulatory escalations and system issues

• Develop and maintain a comprehensive compliance program that aligns with applicable laws, regulations, and industry best practices. • Establish and communicate compliance policies and procedures throughout the organization. • Conduct regular risk assessments to identify compliance gaps and implement corrective measures. • Implement effective compliance monitoring and testing processes to ensure ongoing compliance. • Maintaining and implementing OFAC and AML policies and procedures in accordance with applicable laws and regulations. • Evaluating and fine tuning code of conduct, employee non-disclosures and confidentiality and invention assignment agreements. • Monitor changes in laws, regulations, and industry guidelines and update the compliance program accordingly. • Interpret and communicate the impact of regulatory requirements to relevant stakeholders within the organization. • Ensure compliance with all applicable laws, regulations, and licensing requirements. • Prepare and submit necessary regulatory filings and reports accurately and in a timely manner. • Collaborate with internal teams to address compliance issues and implement remedial actions. • Manage / lead market conduct exams and other regulatory investigations in conjunction with Legal and other areas of the business. • Develop and update compliance policies and procedures to reflect changes in regulations and business practices. • Establish and implement training programs to educate employees on compliance requirements. • Respond to compliance-related inquiries and provide guidance to employees on compliance matters. • Regularly assess the effectiveness of compliance training and make improvements as needed. • Develop and implement monitoring and auditing procedures to ensure ongoing compliance. • Conduct regular compliance assessments and internal audits to identify potential risks and areas for improvement. • Prepare reports on compliance activities, including identified issues, remediation efforts, and compliance metrics. • Provide regular updates to senior management and the General Counsel on the status of compliance initiatives. • Collaborate with internal and external auditors to facilitate compliance audits and reviews.

• Conduct advanced GL audit reviews for both internal and vendor audits, ensuring consistent quality, accuracy, and compliance across all sources. • Validate exposure calculations including sales, payroll (as applicable), subcontractor costs, and construction-related labor, materials, and contract values. • Apply specialized expertise in construction risks (carpentry, remodeling, GC operations, subcontractor structures) and large grocery/retail risks with complex or multi-department operations. • Confirm accurate classification for multi-class businesses, including retail + installation, service + sales, mixed operations, and diverse construction activities. • Ensure supporting documentation (COIs, subcontractor lists, sales ledgers, job summaries, financials) fully reconciles with final exposures. • Review Descriptions of Operations (DOOs) for clarity, completeness, and alignment with exposure and classification determinations—especially for variable risks such as construction and large retail chains. • Identify misclassifications, documentation gaps, unsupported exposure adjustments, and systemic issues; provide clear, actionable corrective guidance. • Create and document risk reviews to highlight key operational changes identified during audit, raising potential policy updates or classification revisions to Underwriting as needed. • Serve as a subject-matter expert (SME) in ISO/GL class codes, construction-related exposures, subcontractor handling, and large multi-department grocery/retail classifications.