If you're passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide's Property and Casualty team could be the place for you!
Job Description SummaryJOB SUMMARY: Investigates, evaluates, negotiates and brings to a final resolution personal lines material/physical damage Total Loss or Fire & Theft claims of a moderate to severe nature. Promotes and provides ""On Your Side"" customer service. Responsible for the handling of claims in accordance with prescribed authorization and claims best practices.
RELATIONSHIP: Reports to Reports to Claims Manager
DIRECT REPORTS: None
1. Promptly and effectively handles to conclusion all assigned claims with little to no direction and oversight. Makes decisions within delegated authority as outlined in company policies and procedures. Adheres to high standards of professional conduct consistent with the delivery of superior service.
2. Initiates and conducts follow-ups via proficient use of claims systems and related business systems.
3. Verifies and proper policy coverages and applies best claims practices to conclude assigned cases in accordance with company guidelines. Adheres to high standards of professional conduct while providing delivery of superior claims service.
4. Opens, closes and adjusts reserves in accordance with company practices designed to ensure reserve adequacy. Recommends Special Reserves where necessary. Establishes and authorizes adequate reserves and claims payments within the delegated authority.
5. Maintains current knowledge of: multiple insurance lines; court decisions; current guidelines in the claims function; and policy changes and modifications. May be required to maintain knowledge of other functions within MD discipline. This may require attendance at various seminars and/or training sessions.
6. Submits administrative reports as required.
7. Partners with SIU and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for suit, trial, or subrogation. (Property/MD/Casualty).
8. Partners with SIU and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for suit, trial, or subrogation. (Property/MD/Casualty).
9. Delivers a positive On-Your-Side customer service experience to all internal, external, current and prospective Nationwide customers.
10. Other duties as assigned.
Education: Undergraduate degree or equivalent experience.
Licenses/Designations: State licensing where required. Successful completion of required/applicable claims certification training/classes. Participation in technical insurance or industry coursework preferred (CPCU, ICAR, ASE)
Experience: Three to Five years successful experience in customer service and/or claims handling required. Material/physical damage experience preferred. Related repair industry experience a plus.
Knowledge: Demonstrated knowledge of customer service principles. Insurance company operations and multiple property casualty insurance lines of business. Material/physical damage repair processes, vendor management, customer service techniques, and all related claims systems. Demonstrated knowledge and adherence to best claims practices. Participation in technical insurance or industry coursework preferred (CPCU, ICAR, ASE)
Skills/Competencies: Proven ability to meet customer needs and provide exemplary service by informing customers of the claims process and ensuring a positive customer experience. Excellent customer focus and proven ability to proactively meet customer needs. General knowledge of insurance theory and practices, insurance contracts and their application. Familiarity with claims processing and claims best practices and procedures preferred. Proven knowledge of insurance contracts, medical terminology, workers compensaiton, and the legal aspects of court procedures affecting legal liability for all lines of insurance. Knowledge of claims systems.Proven analytical skills necessary to make decisions and resolve conflict in such areas as application of coverage to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions. Proven ability to establish repair requirements and cost estimates for extensive losses and serves as a subject matter expert on respective claims projects. Proven organizational skills to effectively prioritize increased and more complex workloads.Demonstrates strong but flexible standards and can act different, can be seen as balanced based on the conflicting demands of the position. Excellent written and verbal communication skills necessary to effectively communicate and/or negotiate with policyholders, claimants,attorneys, agents, and general public. Demonstrated leadership capabilities to effectively train, coach, and provide feedback to less experienced associates. Ability to operate a PC and related software.
Values: Regularly and consistently demonstrates the Nationwide Values and Guiding Behaviors.
Staffing Exceptions to the above Minimum Job Requirements must be approved by: Business Unit Executive and Human Resources.
Working Conditions: Office claims environment. May require ability to sit and operate telephone and personal computer for extended periods of time. Must be willing to work irregular hours and to travel with possible overnight requirements. Must be available to work catastrophes (CAT) requiring travel to CAT sites with multiple onsite responsibilities and/or for extended periods of time. Extended and/or non-standard hours as required.
Credit/Background Check: Due to the fiduciary accountabilities within this job, a valid credit check and/or background check will be required as part of the selection process.
ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.
Job Evaluation Activity: Edited 5/2/11 JTG#claims