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!
We are looking for individuals to join our Bodily Injury team.
Ideal candidates will have 18 months or more of claims experience (highly preferred).
The ideal candidate for this role will be available to work 8am-430pm PST and/or MST.
This role is posted as a Specialist II (E3), but can be filled at another level based on experience and skills.
Colorado Residents: Email email@example.com for salary information.
Job Description Summary
Do you have a strong desire to resolve insurance claims by providing prompt, courteous and fair service to customers? Are you a skilled investigator, negotiator and communicator? If you thrive in an environment where you can problem-solve claims resolution, while following processes that provide fair resolution, customer satisfaction and cost management, then we want to hear from you!
As a Claims Specialist, you'll investigate and effectively resolve bodily injury personal lines liability claims via phone, web chat or email. We'll count on you to adjust serious exposure claims requiring investigation, liability evaluation and negotiation and expedite settlement and control of average loss cost and litigation expense.
Utilizes various methods of settlement in cases where warranted; assigns cases to outside vendors as needed. Makes appropriate use of structured settlement on all applicable cases.
Handles all assigned claims with moderate direction and oversight. Makes decisions within delegated authority and adheres to high standards of professional conduct consistent with the delivery of superior service.
Initiates and conducts follow-ups via proficient use of claims systems and related business systems.
Determines proper policy coverages and, where necessary, investigates, evaluates, negotiates and equitably settles all assigned liability/bodily injury claims cases, according to company policies and procedures, at values commensurate with damages sustained.
Opens, closes and adjusts reserves according to company practices designed to ensure reserve adequacy. Adheres to file conferencing notification and authority procedures.
Partners with Special Investigation Unit and Subrogation to identify fraud and recovery opportunities.
Maintains and develops current knowledge of assigned insurance lines, court decisions which may impact the claim function, current guidelines and policy changes and modifications. This may require attendance at various seminars or training sessions.
Submits severe incident reports, reinsurance reports and other information to claims management as needed.
Assists or prepares files for lawsuit, trial or subrogation.
Uses all internal resources, e.g., special investigation, medical, claim legal, when appropriate in the handling and resolution of claims.
Delivers a positive customer service experience to all internal, external, current and prospective Nationwide customers.
May perform other responsibilities as assigned.
Reporting Relationships: Reports to Claims Manager; individual contributor role.
Typical Skills and Experiences:
Education: Undergraduate degree or equivalent experience preferred.
License/Certification/Designation: State licensing where required. Successful completion of required claims certification schools/classes.
Experience: One to three years of customer service and/or claims processing/handling experience preferred. Bodily injury claims experience preferred.
Knowledge, Abilities and Skills: General knowledge of insurance theory and practices, insurance contracts and their application. General knowledge of causality claims practices, systems, medical terminology and liability analysis preferred. Confirmed knowledge of insurance contracts and the legal aspects of court procedures affecting legal liability for all lines of insurance. Proven ability to meet customer needs and provide exemplary service by informing customers of the claims process and ensuring a positive customer experience. Analytical skills necessary to make decisions/resolve issues such as application of coverage's to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions, and direct repaid shop claims management. Ability to work in a fast paced and team-based environment. Organizational skills to effectively prioritize and handle increased workloads. Demonstrated proficiency of written/verbal communication skills for contact and/or negotiations with policyholders, claimants, repair persons, attorneys, agents, and the public in general. Ability to efficiently operate personal computer and software for claims-related and other business applications.
Other criteria, including leadership skills, competencies and experiences may take precedence.
Staffing exceptions to the above must be approved by the business unit executive and HR Business Partner.
Values: Regularly and consistently demonstrates the Nationwide Values.
Overtime Eligibility: Not Eligible (Exempt
Working Conditions: Normal office environment. May require ability to sit and operate phone 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 on-site responsibilities and/or for extended periods of time. Extended and/or non-standard hours as required.
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.
Credit/Background Check: Due to the fiduciary accountabilities within this job, a valid credit and/or background check will be required as part of the selection process.#claims