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 commercial bodily injury claims of low severity and complexity. We’ll count on you to promote and provide exemplary customer service. This may be accomplished through telephone or in person claims handling. You’ll be responsible for handling claims according to prescribed authorizations.
- Responsible for managing 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.
- Determines proper policy coverages and applies best claims practices to conclude, investigate, evaluate and negotiate assigned material/physical damage claims cases according to company guidelines.
- Opens, closes and adjusts reserves in alignment with company practices designed to ensure reserve adequacy. Recommends special reserves per company guidelines. Complies with file conferencing notification and authority procedures.
- 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
- Submits severe incident reports, reinsurance reports and other information to claims management as needed.
- Partners with Special Investigative Unit (SIU) and Subrogation to identify fraud and subrogation opportunities.
- Assists or prepares files for lawsuit, trial, or subrogation.
- Initiates and conducts follow-up communications using claims systems and related business systems.
- Delivers a positive customer service experience to all internal, external, current and prospective Nationwide customers.
Reporting Relationships: Reports to Commercial Claims Manager. Direct and indirect reports not typically assigned.
Education: Undergraduate studies in business administration or related field preferred or relevant experience.
License/Certification/Designation: State licensing where required. Successful completion of required/applicable claims certification training/classes.
Experience: Zero to three years of customer service or leadership experience, which can be showcased through classroom projects, on-campus leadership roles, athletics, and/or clubs and organizations.
Knowledge, Abilities and Skills:
- Strong written and oral communication skills.
- The ability to demonstrate and share in detail problem-solving expertise
- The ability to relentlessly evolve.
- Demonstrate the ability to provide on-going exceptional customer service.
Working Conditions: Inside or field claims environment. May require ability to sit and use 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 and 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 outside 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) requiring travel to CAT sites with multiple onsite responsibilities and/or for extended periods of time. Extended and/or non-standard hours as required.