*Estimating experience, I-CAR, and ASE knowledge preferred.
*This position will be work from home with a company car, servicing the Richmond, VA Territory.
*Property or prior MD claims experience is a plus.
JOB SUMMARY: Investigates and resolves personal lines material/physical damage claims via telephone or face-to-face claims handling. Promotes and provides "On Your Side" customer service. Responsible for the handling of claims in accordance with prescribed authorizations and claims best practices.
RELATIONSHIP: Reports to Claims Manager
DIRECT REPORTS: None
1. Promptly and effectively handles to conclusion all assigned claims 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.
2. Determines proper policy coverages and applies where necessary applies best claims practices to conclude, investigate, evaluate, and negotiate assigned material/physical damage claims cases in accordance with company guidelines. Adheres to high standards of professional conduct while providing delivery of superior claims service.
3. Opens, closes and adjusts reserves in accordance with company practices designed to ensure reserve adequacy. Recommends Special Reserves where necessary. In accordance with Corporate Reserving Guidelines. Adheres to file conferencing notification and authority procedures.
4. Maintains and develops current knowledge of: assigned insurance lines; court decisions which may impact the claims function; current guidelines in the claims function; and policy changes and modifications. This may require attendance at various seminars or training session
5. Submits severe incident reports, reinsurance reports and other information to claims management as needed.
6. Partners with SIU and Subrogation to identify fraud and subrogation opportunities
7. Participates in preferred/direct repair shop claims management. Assists or prepares files for suit, trial, or subrogation.
8. Initiates and conducts follow-ups via proficient use of claims systems and related business systems
9. Delivers a positive On-Your-Side customer service experience to all internal, external, current and prospective Nationwide customers.
10. Adheres to high standards of professional conduct while providing delivery of superior claims service.
11. Other duties as assigned.
Education: Undergraduate degree or equivalent experience preferred.
Licenses/Designations: State licensing where required. Successful completion of required/applicable claims certification training/classes.
Experience: One to three years related experience in customer service and/or claims handling. Material/physical damage or related repair industry experience a plus.
Knowledge: General knowledge of customer service principles. Demonstrated knowledge of claims handling and claims best practices. General knowledge of insurance theory and practices, insurance contracts and their application, and automobile estimating. Familiarity with automated claims systems. Participation in technical insurance or industry coursework preferred (CPCU, ICAR, ASE)
Skills/Competencies: 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 conflicts 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 repair shop claims management. Ability to work in a fast paced and team based environment. Organizational skills to effectively prioritize and manage 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.
Values: Regularly and consistently demonstrates the Nationwide Values and Guiding Behaviors.
Staffing Exceptions to the above Minimum Job Requirements must be approved by: Business Unit Executive and Human Resources.
Working Conditions: Field or office claims environment. May require ability to sit and operate telephone and personal computer for extended periods of time. Representatives may be required to operate an automobile and have a valid driver's license with a safe driving record. Must be able to make physical inspections of accident scenes. Must be able to climb, balance at various heights, stoop, bend, and/or crawl to inspect vehicles and structures. Must be able to work out of doors in all types of weather. 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 onsite responsibilities and/or for extended periods of time. Extended and/or non-standard hours as required.
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.
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.
Nationwide Mutual Insurance Company - 9 months ago