Associate Claims Specialist, Cas
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JOB SUMMARY: Develops skills and acquires knowledge necessary to investigate and resolve personal lines casualty claims via telephone or face to face investigation or negotiation. Responsible for the handling of claims in accordance with prescribed authority and according to claims best practices. Promotes and provides "On Your Side" customer service. Develops skills and acquires knowledge necessary to investigate and resolve personal lines casualty claims via telephone or face to face investigation or negotiation. Responsible for handling of claims in accordance with prescribed authority and best claims practices.
Reports to: Claims Manager
Prepare files for reassignment as needed.
Completes training necessary to promptly and effectively handle claims to conclusion. Adheres to high standards of professional conduct while providing the delivery of superior claims service.
Authorizes and/or approves all claims payments within the delegated authority or within the maximum limits as outlined in company policies and procedures.
Determines proper policy coverages, and where necessary, investigates, evaluates, negotiates and equitable settles all assigned casualty claims cases in accordance with company guidelines. Learns to utilize best claims practices.
Establishes and authorizes reserves and claims payments within the delegated authority. Recommends for approval all claims payments beyond delegated authority in accordance with company practices and procedures.
Learns to conduct settlement negotiations with claimants and policy holders.
Builds knowledge of: personal lines material/physical damage claims; court decisions which may impact the claims function; current guidelines in the claims function; and policy changes and modifications.
Submits administrative reports as required.
Initiates and conducts follow-ups via proficient use of the claims handling system or other related systems.
Learns to partner with SIU and Subrogation to identify fraud and subrogation opportunities.
May serve as the contact for personal lines material damage claims including non-standard; partners with SIU to identify fraud. Identifies subrogation opportunities.
Delivers a positive On-Your-Side customer service experience to all internal, external, current and prospective Nationwide customers.
Other duties as assigned.
Education: Undergraduate degree or equivalent experience.
Licenses/Designations: State licensing where required. Successful completion of required claims certification schools/classes.
Experience: Experience in customer service or medical environment including flexible work schedule.
Knowledge: General knowledge of customer service principles and/or insurance theory and practices. Familiarity with claims processing, policies and procedures preferred. Familiarity with automated claims systems and claims best practices desirable.
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. Ability to acquire skills necessary to make decisions and resolve conflicts in such areas as application of coverages to submitted claims, application of laws of jurisdiction to investigatory facts, application of policy exclusions and exceptions. Ability to effectively prioritize work. Ability to work in a fast paced and team based environment.Written and verbal communication skills for contact and/or negotiation with policyholders, claimants, repairpersons, attorneys, physicians, agents and the general public. 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: Normal office claims environment. May require ability to sit and operate telephone and personal computer for extended periods of time. 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 on-site responsibilities and/or for extended periods of time. Overtime 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.
Job Evaluation Activity: Edited 5/2/11 JTG
Additional Job Description
We are growing our Casualty Non-Injury Claims Specialist team in Lone Tree, Colorado where we support our members who own Nationwide’s auto insurance.
We have fun here working together as a team while also realizing the importance of working independently. Flexibility and initiative are the keys to ensuring customer satisfaction - accurate claim processing the first time, every time.
The main goal of this team is to deliver thoughtful, comprehensive service that exceeds customer expectations during stressful situations.
A typical day in the life of a Claims Specialist:
Answering complex calls while remaining positive
Creating comprehensive liability reports efficiently, following claims through investigation to completion
Collaborating with policyholders, claimants, agents, and adjusters throughout process
Determining coverage limits and reserve amounts and researching court decisions, company policy, and guidelines
Escalating severe incident or reinsurance reports when necessary
Organizing files for trial, suit, or subrogation
Teaming up with internal departments to identify fraud and subrogation instances
Jumping in to complete other tasks as needed
Compensation & Benefits
You receive a starting salary of $47,200 with opportunities to increase salary based on performance. Other benefits include:
Enjoying time with your family/pets/yourself (we understand) with up to 18 days of paid time off and 9 – 10 paid holidays per year
10-15% shift differential on qualifying shifts
A 401k match and company-funded pension plan
Medical, dental, and vision insurance (part of our Wellness Program)
Up to $5250 in tuition reimbursement per year after your first year
Flexible scheduling and/or workspaces
Excellent opportunities for growth and promotion
Network of diverse employee resource groups
Special discounts through Plenti Rewards and perks through Abenity
Training & Work Schedule
Your career at Nationwidestartswith an award-winning 2 -week training program that is designed to set you up for success and confidence in your new role. Your training schedule will be Monday – Friday, 8:00am - 4:30pm followed by a regular work schedule of Monday through Friday, 8:00 am to 4:30, 9:00 am to 5:30 pm or 10:00 am to 6:30 pm.
Job ID: 52883
We are Nationwide, a company of great people doing great things. We care deeply about doing what’s right, and we work hard to make an impact for each other, our associates, our members, our partners and our communities.