Claims Specialist II, Casualty Non-Injury

Additional Job Description

We are currently filling (4) positions for Claims Specialist II for NILC
This position will be filled at a Claim Specialist II level

This role is not limited to one location/territory

Compensation for this band is an E band.

Preferred:
Estimating Experience

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Non-Injury Liability, Casualty (NILC) experience

Adaptable to a fast-paced environment

Leadership + Lean experience is preferred

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 complex non-injury personal lines liability claims via phone, internet or email.

Job Description

Key Responsibilities:

• Handles all assigned claims with minimal 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 outstanding service.

• Identifies subrogation and contribution for subrogation. May initiate or respond to inter-company arbitration.

• Determines proper policy coverages and, where necessary, investigates, evaluates, negotiates and equitably settles all assigned liability cases according to company policies and procedures at values commensurate with damages sustained.

• Partners with Special Investigation Unit and Subrogation to identify fraud and recovery 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; individual contributor role.

Typical Skills and Experiences:

Education: Undergraduate degree or equivalent experience preferred. Postgraduate studies in medical field or law desirable.

License/Certification/Designation: State licensing where required. Successful completion of required claims certification schools/classes.

Experience: Three to five years of related casualty claims handling experience or related medical experience.

Knowledge, Abilities and Skills: Validated knowledge of insurance theory and practices, insurance contracts and their application. Excellent customer service skills and ability to proactively meet customer needs. Familiarity with claims processing and claims practices and procedures preferred. Confirmed knowledge of medical terminology, workers compensation, and the legal aspects of court procedures affecting legal liability for all lines of insurance. Knowledge of claims systems. Analytical skills vital to making decisions and resolving issues in such areas as application of coverage to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions. Ability to establish repair requirements and cost estimates for extensive losses and serves as a subject matter authority on respective claims projects. Strong social skills to optimally prioritize increased and more complex workloads. Demonstrates strong but flexible standards, balanced based on the conflicting demands of the position. Excellent written and verbal communication skills necessary to effectively communicate and/or influence policyholders, claimants, attorneys, agents, and general public. Demonstrated leadership capabilities to effectively train, coach, and mentor less experienced associates. Able to provide outstanding customer service by informing customers of the claims process. 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.

Job Conditions:

Overtime Eligibility: Not eligible. (Exempt)

Working Conditions: Office environment. Prolonged periods of sitting at personal computer and extensive use of keyboard while taking telephone calls; must use a telephone headset.  Non-standard hour’s possible-flexibility of schedule is desired. 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. 

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.