Handles all assigned claims promptly and effectively with moderate 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.
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 at values commensurate with damages sustained.
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 claims 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.
Serves as the single point of contact for personal lines material damage claims, including non-standard 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.
Knowledge, Abilities and Skills: General knowledge of insurance theory and practices, insurance contracts and their application. Familiarity with claims processing, systems, practices and procedures preferred. Proven knowledge of insurance contracts, medical terminology and the legal aspects of court procedures affecting legal liability for all lines of insurance. Proven ability to meet customer needs and provide outstanding 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, team environment. Organizational skills to effectively prioritize and handle increased workloads. Excellent 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 the need arises.
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.
Additional Job Description
Additional Job Description
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.
For the right candidates, we are able to fill this opportunity in a Work From Home (remote) setting.
Schedules may fall between 8:00 a.m. and 6:30 p.m. local time, Monday through Friday.
*Start date for this role is targeted for 11/1
For Internal Use Only: This opportunity is posted as a Claims Specialist I (D3), but can be filled as a Associate Claims Specialist (C3) based on skills and qualifications.
Highly preferred, but not required:
Customer service experience, call center experience is a plus
Career focused, looking for growth opportunity
Adaptability, willingness to learn
Insurance/claims experience is a plus
Auto claims experience is a plus
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Nationwide Mutual Insurance Co. Des Moines, Iowa