Field Claims Specialist III, Affluent - $2500 SIGN ON BONUS

A $2500 SIGN-ON BONUS will be given to all external candidates hired into this role. The bonus is paid in the first pay period after 30 days of employment.  

Territory: Responsible for member claims in Pennsylvania, New Jersey, New York and Connecticut.

• This is a work-from-home position with travel to policy locations (3 days a week on average). The selected individual must reside in the respective territory.

Job Description Summary

Are you poised and ready for an exciting opportunity to resolve unique and challenging insurance claims? Our Private Client team operates as a niche, stand-alone business, supported by the scale and resources of the entire Nationwide enterprise. If you have the maturity, confidence and resourcefulness to provide an outstanding level of service to sophisticated and savvy customers, we want to hear from you!

As a Field Claims Specialist, you'll evaluate, negotiate and resolve large personal lines property losses (structure and contents) from $50K to $350K, while maintaining high member engagement. These losses will be high exposure, complex, coverage-laden and involve high profile, affluent and high net worth customers. Property involved is likely to include high end building material, fine arts, antiques and collectables. Some homes may involve custom builds, designs and materials.

Job Description

Key Responsibilities:

• Conducts on-site field investigations and/or field re-inspections of large exposure personal lines claims and coordinates rebuilding of damages with contractors, various trades and architects. Will support and partner with Nationwide Excess & Surplus/Specialty (E&S) and Nationwide Indemnity (NWI).

• Participates in complex litigated and non-litigated claims and provides technical assistance and consultation to state/regional leaders and claim associates.

• Completes onsite Xactimate (software tool used for estimations) estimates, thorough investigations, photos and narrative reports. Obtains medical reports, appraisals, estimates of property damage and evaluates bodily injury claims as needed. When necessary, coordinates and reviews work performed by vendors.

• Mentors field claims associates to develop their technical and building knowledge and may provide advice, counsel or formal training.

• Delivers a outstanding customer service experience with clear service expectations to all internal, external, current and prospective customers. Adheres to high standards of professional conduct while providing the delivery of superior claims service support and work product.

• Participates in catastrophe (CAT) events as requested by the Technical and/or field office.

• Prepares/reviews reservation of rights, non-waiver agreements and denials of coverage when appropriate.

• Opens, closes and adjusts reserves in accordance with company practices designed to ensure reserve adequacy. Recommends special reserves where necessary.

• Maintains current knowledge of court decisions which may impact the claims function, current principles and practices, material damage techniques and repair technology innovations and policy changes and modifications.

• Maintains knowledge of other functions within assigned subject area. This may require attendance at various seminars or training sessions.

• Pays claims accurately based on policy provisions, state mandates and/or fee schedules. Authorizes and/or approves all claim payments, within granted authority, which may include litigation expense. Creates and analyzes severe incident reports, reinsurance reports and other information to corporate office, claims management, and underwriting

• Partners with Special Investigations Unit and Recovery to identify fraud and subrogation opportunities. Assists or prepares files for lawsuit, trial or subrogation (property, material damage, casualty).

• Consults claims staff and defense counsel for discovery processes, lawsuit file/trial strategy as related to case-specific issues.

May perform other responsibilities as assigned.

Reporting Relationships: Reports to Claims Manager.

Typical Skills and Experiences:

Education: Undergraduate degree or equivalent experience preferred.

License/Certification/Designation: State licensing where required. Professional development such as IIA or CPCU preferred

Experience: Five to eight years of claims handling experience, including two years handling field property Large Loss or complex claims, all lines, personal and/or errors and omissions including bodily injury, extensive material damage and/or questionable liability. Some positions may require litigation experience.

Knowledge, Abilities and Skills: Proven knowledge of insurance theory and practices, insurance contracts and their application. Advanced knowledge of causality claims practices, medical terminology and the legal aspects of court procedures affecting legal liability for all lines of insurance.

Demonstrated ability to meet customer needs and provide exemplary service by informing customers of the claims process and ensuring a positive customer experience. Advanced analytical and problem solving skills necessary to make decisions and resolve conflict in application of coverage to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions. Validated ability to establish repair requirements and cost estimates for property losses. Proven ability to direct defense counsel in suit handling from inception to conclusion. Organizational skills to effectively prioritize work. Verbal and written communication skills necessary to effectively communicate and/or negotiate with policyholders, claimants, repair persons, attorneys, physicians, agents, and general public. Confirmed ability to operate personal computer and related claims and business software.

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: Not Eligible (Exempt)

Working Conditions: Normal office or field claims environment. May require ability to sit and operate telephone and personal computer for extended periods. Must be able to make physical inspections of property loss sites; climb ladders, balance at various heights, stoop, bend and/or crawl to inspect vehicles and structures; work outside in all types of weather. Must be willing to work irregular hours and to travel with possible overnight requirements. May be on-call. Must be available to work catastrophes (CAT). Extended and/or non-standard hours as the need arises. Must have a valid driver’s license with satisfactory driving record in accordance with Nationwide standards. 

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 check and/or background check will be required as part of the selection process.

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