JOB SUMMARY: Investigates and resolves personal lines property damage claims via phone and face-to-face claims handling of a moderate to severe nature. Promotes and provides "On Your Side" customer service. Responsible for the handling of claims in accordance within prescribed authority and adhering to best claims practices.
- This position will be work from home with a company car, servicing the Mid-Atlantic territory (MD/VA).
- Prior claims experience preferred.
- This position may be staffed at another level, based on experience and/or qualifications.
RELATIONSHIP: Reports to Reports to Claims Manager
DIRECT REPORTS: None
1. Promptly and effectively handles to conclusion all assigned claims with little to no 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 best claims practices to conclude assigned 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 current knowledge of insurance and applicable product/services; 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 and/or training sessions.
5. Maintains current knowledge of local industry repair procedures and local market pricing.
6. Submits severe incident reports, reinsurance reports and other information to claims management as needed.
7. Partners with SIU and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for suit, trial, or subrogation. (Property/MD/Casualty).
8. Initiates and conducts follow-ups via proficient use of the claims systems and other 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.
Licenses/Designations: State licensing where required. Successful completion of required/applicable claims certification training/classes.
Experience: Three to five years related property claims experience. Experience in a customer service environment including flexible work schedules and extended work hours preferred.
Knowledge: General knowledge of insurance theory and practices, and contracts and their application. Property estimating and automated claims systems. Proven knowledge of the investigation, negotiation and settlement activities used to resolve extensive property damage claims.
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 and problem solving skills necessary to make decisions and resolve conflict in such areas as application of coverages 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 property losses. Ability to evaluate and successfully negotiate property claims. Organizational skills to effectively prioritize work. Command of written and verbal communication skills for contact and/or negotiation with policyholders, claimants, repairpersons, attorneys, agents and the general public. Ability to efficiently operate a personal computer and related claims and business software. Provided leadership to to less experienced claims associates
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: Normal office or field 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 property loss sites. Must be able to climb ladders, 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. May be on-call. Must be available to work catastrophes (CAT). 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.