RELATIONSHIP: Reports To Claims Manager. No Direct Reports.
1. Promptly and effectively handles to conclusion assigned claims with little to no direction and oversight that may include complex and catastrophic casualty losses. Makes decisions within delegated authority, recommends settlement values in the disposition of serious and sometimes complex claims as outlined in company policies and procedures. Adheres to high standards of professional conduct consistent with the delivery of superior service.
2. Utilizes various methods of settlement in those cases where warranted; assigns cases to outside vendors as warranted.
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: assigned insurance lines; court decisions that may affect 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. Serves as a mentor to less experienced claims associates and assists with training/presentations as assigned by claims management.
6. Partners with SIU and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for suit, trial, or subrogation. (Property/MD/Casualty).
7. Oversees defense counsel in all lawsuit activities from inception throughout the life of the claim.
8. Delivers a positive On-Your-Side customer service experience to internal, external, current and prospective Nationwide customers.
9. Perform other duties as assigned.
Education: Undergraduate studies in business administration or related field preferred and/or relevant experience
Licenses/Designations: Successful completion of required claims certification schools/courses. Professional development such as IIA or CPCU preferred. State licensing where required.
Experience: Five years commercial property claims handling experience preferred.
Knowledge: Proven knowledge of medical, legal and/or commercial claims terminology, state regulations, claims processes, best practices, and customer relationship management. Advanced knowledge of insurance theory and practices, insurance contracts and their application. Excellent customer focus and proven ability to proactively meet customer needs. Analytical skills necessary to make decisions and resolve conflict in application of coverage, laws of jurisdiction to investigation facts, policy exclusions and exceptions. Proven organizational skills to effectively prioritize increased and more complex workloads. Demonstrates strong but flexible standards and can be seen as balanced based on the conflicting demands of the position. Excellent written and verbal communication skills necessary to effectively communicate and/or negotiate with various audiences. Demonstrated leadership capabilities to effectively train, coach, and provide feedback to less experienced associates. Knowledge of claims systems. Advanced knowledge of claims best claims practices used to resolve serious and/or high exposure/large loss commercial 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 skills used to make independent decisions and resolve conflict; proven ability to coordinate with defense counsel in the handling of cases involving serious and sometimes complex commercial property damage issues from inception through trial. Command of written and verbal communication skills for contact and/or negotiation. Organizational skills to effectively establish work priorities in accordance with Best Claims Practices. Ability to operate PC and related software.
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: Inside or field claims environment. May require ability to sit and use telephone and personal computer for extended periods. 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 out-of-doors in all types of weather. Must be able and willing to work irregular hours and to travel with possible overnight requirements. May be on-call. Must be available to work catastrophes (CAT).
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.
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.
Job Evaluation Activity: Edited 5/2/11 JTG
Internal Number: 59694
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