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Claims Specialist I, Commercial Casualty

  • Company
    Nationwide Mutual Insurance Company
  • Location
    Denver, CO
  • Category
  • Posted On
    July 15, 2017

JOB SUMMARY: Primarily investigates  commercial bodily injury claims of low severity and complexity. Promotes and provides “”On Your Side”” customer service. This may be accomplished through telephone or face-to-face claims handling.  Responsible for the handling of claims in accordance with prescribed authorizations.

RELATIONSHIP: Reports to Reports to Commercial Claims Manager
DIRECT REPORTS: None

JOB RESPONSIBILITIES:

  1. Promptly and effectively handles to conclusion all 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.
  2. Determines proper policy coverages and applies where necessary applies best claims practices to conclude, investigate, evaluate, and negotiate assigned material/physical damage claims 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 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
  5. Submits severe incident reports, reinsurance reports and other information to claims management as needed.
  6. Partners with SIU and Subrogation to identify fraud and subrogation opportunities
  7. Assists or prepares files for suit, trial, or subrogation.
  8. Initiates and conducts follow-ups via proficient use of claims systems and 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.

JOB REQUIREMENTS:

Education:

  • Undergraduate studies in business administration or related field preferred and/or relevant experience

Licenses/Designations:

  • State licensing where required.
  • Successful completion of required/applicable claims certification training/classes.

Experience:

  • One to three years related experience in casualty claims  or equivalent.
  • Prefer exposure to commercial claims.

Knowledge:

  • Demonstrated knowledge of best claims practices to resolve claims of low severity and complexity.
  • General knowledge of insurance theory and practices, insurance contracts and their application, and property damage estimating.
  • Ability to operate various claims systems and related software.

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 necessary to make decisions/resolve conflicts such as application of coverages to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions.
  • Ability to successfully negotiate commercial claims of low severity and complexity.
  • Organizational skills to effectively prioritize work.
  • Command of written/verbal communication skills for contact and/or negotiations.
  • Ability to operate PC and related software.
  • Must be able to climb, 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.
  • 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.

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.

JOB CONDITIONS:

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 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).

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.

How to Apply

Click Here to apply

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