Claims Specialist I, Casualty Non-Injury Liability (or Associate Claims Specialist)

We are looking for individuals to join our Non-Injury Liability Claims team at our Grandview Heights, OH; Des Moines, IA; and San Antonio, TX offices. This is an all location remote role and is not subject to OH, IA or TX.

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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 an Associate Claims Specialist, you'll develop skills and acquire knowledge to investigate and resolve personal lines casualty claims via phone or face-to-face investigation or negotiation. We'll count on you to handle claims according to prescribed authority and optimal claims practices.

Job Description

Key Responsibilities:

• Prepare files for reassignment as needed.

• Completes training necessary to promptly and effectively handle claims to conclusion. Adheres to high standards of professional conduct while providing the delivery of outstanding service.

• Authorizes and/or approves all claims payments within the delegated authority or within the maximum limits as outlined in company policies and procedures.

• Determines proper policy coverages, and where necessary, investigates, evaluates, resolves and equitably settles all assigned casualty claims cases according to company guidelines. Learns to use best claims practices.

• Establishes and authorizes reserves and claims payments within the delegated authority. Recommends for approval all claims payments beyond delegated authority according to company practices and procedures.

• Learns to conduct settlement negotiations with claimants and policy holders.

• Builds knowledge of personal line material/physical damage claims, court decisions which may impact the claim function, current guidelines in the claims function and policy changes and modifications.

• Submits administrative reports as required.

• Initiates and conducts follow-ups via proficient use of the claims handling system or other related systems.

• Learns to partner with Special Investigation Unit and Subrogation to identify fraud and subrogation opportunities.

• May serve as the contact for personal lines material damage claims including non-standard; partners with SIU to identify fraud. Identifies subrogation opportunities.

• 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.

Typical Skills and Experience:

Education: Undergraduate degree or equivalent experience.

Licenses/Designations/Certifications: State licensing where required. Successful completion of required claims certification schools/classes.

Experience: Experience in customer service or medical environment including flexible work schedule.

Knowledge, Abilities and Skills: General knowledge of customer service principles and/or insurance theory and practices. Familiarity with claims processing, policies and procedures preferred. Familiarity with automated claims systems and optimal claims practices desirable. Proven ability to meet customer needs and provide exemplary service by informing customers of the claims process and ensuring a positive customer experience. Ability to acquire skills necessary to make decisions and resolve issues in application of coverages to submitted claims, application of laws of jurisdiction to investigatory facts, application of policy exclusions and exceptions. Ability to effectively prioritize work. Ability to work in a fast paced and team-based environment. Written and verbal communication skills for contact with policyholders, claimants, repairpersons, attorneys, physicians, agents and the general public. 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.

Other criteria, including leadership skills, competencies and experiences may take precedence.

Staffing exceptions to the above must be approved by the hiring manager’s leader and HR Business Partner.

Values: Regularly and consistently demonstrates the Nationwide Values.

Job Conditions:

Overtime Eligibility: Eligible (Non-Exempt)

Working Conditions: Office environment. Must be available to work catastrophes (CAT) which may include working extended periods of time including holidays and weekends over the phone or in office environment. Field CAT duty is not required for this role. May require ability to sit and operate telephone and personal computer for extended periods of time.

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.

Attention Colorado applicants, the pay range for this position is: