JOB SUMMARY: Investigates, evaluates, and negotiates claims to a successful resolution. File inventory typically includes claims with average claim reserves of $10k up to $25k. Responsible for managing the work and performance of vendors to achieve successful resolution of claims. Has contact with internal and external customers which involves maintaining, developing and influencing relationships. Responsible for meeting the expectations and requirements of internal and external customers.
RELATIONSHIP: Reports to Cathy Maxwell
Investigates, evaluates, and negotiates commercial, personal and professional lines claims to a successful resolution and in compliance with company quality standards. These claims may include first and third party claims of a basic to moderate severity and complexity level.
Responsible for managing the work and performance of vendors to achieve successful resolution of claims.
Responsible for meeting the expectations and requirements of internal and external customers. Responsible for developing and maintaining open and trusting working relationships with insureds in order to gather pertinent information.
Responsible for timely and appropriate evaluation of claims to identify and manage reserves in compliance with company standards.
Maintains current knowledge of: all 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 and training sessions.
Performs other related duties as assigned. For development purposes may be assigned more complex claims including claims with basic litigation.
JOB REQUIREMENTS :
Education: High school diploma or GED Required. College degree preferred. Undergraduate degree or post-graduate degree preferred. Additional education in a particular line of business may be required by the hiring business unit. Insurance coursework preferred.
Licenses/Designations: Associates must obtain the required Federal and/or state licenses/registrations within the time period designated by the business unit. Additional licenses/registrations may be required when new products and services are implemented. If an associate fails or is unable to obtain required licenses/registrations within the time period designated by the business unit, the associate will be ineligible to continue in the position.
Experience: 1-3 years claims handling experience, comparable job related experience or education preferred. Prior multi-jurisdictional, E&S or other specialty lines experience preferred. Familiarity with various types of insurance policies preferred. Specific experience in a particular line of business may be required by the hiring business unit.
Knowledge: Basic Knowledge of commercial insurance and E&S or other specialty insurance helpful. Familiarity with various types of insurance policies preferred. Basic knowledge in a particular line of business such as medical liability, lawyers Errors and Omissions, D&O, arson, property-catastrophe, architecture and engineering, construction, intellectual property/advertising injury, handling/evaluating the total loss of special equipment risks/equipment or other specialty lines/risks, and/or large accounts may be required by the hiring business unit. Basic knowledge of the processes of the independent adjusters and attorneys in order to manage claims and assist in litigation management.
Skills/Competencies: Ability to communicate interpersonally with individuals and groups, via the telephone and in writing. Ability to develop and maintain open and trusting working relationships with insureds in order to gather pertinent information. Ability to effectively manage conflict and practices attentive and active listening. Ability to analyze facts and coverages in order to evaluate damages. Ability to work with and coordinate independent adjusters and attorneys in claims and litigation management.
Values: Regularly and consistently demonstrates the Nationwide Values and Guiding Behaviors.
Staffing Exceptions to the above minimum job requirements must be approved by the: VP and HR VP.
Overtime Eligibility: Not Eligible (exempt)
Working Conditions: Normal office environment.
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 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.
Nationwide is a high-performing organization, and we continue to prove it every day. Our Property and Casualty Division sells a unique mix...