** This position could be filled as a Non-Injury or Med-pay position. This position may be hired at a lower level.**
JOB SUMMARY: Investigates and effectively resolves non-injury personal lines liability claims via telephone, internet or email. Responsible for the disposition of claims in accordance with prescribed authority and according to best claims practices. Promotes and provides ""On Your Side"" customer service. Investigates and effectively resolves personal lines liability claims via telephone. Responsible for the disposition of claims in accordance with prescribed authority and according to best claims practices.RELATIONSHIP: Reports to Claims ManagerDIRECT REPORTS: NoneJOB 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. Initiates and conducts follow-ups via proficient use of claims systems and related business systems3. Determines proper policy coverages, and where necessary, investigates, evaluates, negotiates and equitably settles all assigned liability/bodily injury claims cases in accordance with company policies and procedures at values commensurate with damages sustained.4. Partners with SIU and Subrogation to identify fraud and subrogation opportunities.5. 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 sessions.6. Submits severe incident reports, reinsurance reports and other information to claims management as needed.7. Assists or prepares files for suit, trial, or subrogation. (Property/MD/Casualty)8. May serve as the single point of contact for personal lines material damage claims, including non-standard.9. Delivers a positive On-Your-Side customer service experience to all internal, external, current and prospective Nationwide customers.10. Initiates and conducts follow-ups via proficient use of claims systems and related business systems.11. Other duties as assigned.JOB REQUIREMENTS:Education: Undergraduate degree or equivalent experience preferred.Licenses/Designations: State licensing where required. Successful completion of required claims certification schools/classes.Experience: One to three years of customer service and/or claims processing/handling experience preferred.Knowledge: General knowledge of insurance theory and practices, insurance contracts and their application. Familiarity with claims processing and claims best practices and procedures preferred. Proven knowledge of insurance contracts, medical terminology and the legal aspects of court procedures affecting legal liability for all lines of insurance. Knowledge of claims systems.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 coverage's to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions, and direct repaid shop claims management. Ability to work in a fast paced and team based environment. Organizational skills to effectively prioritize and manage increased workloads. Demonstrated proficiency of written/verbal communication skills for contact and/or negotiations with policyholders, claimants, repair persons, attorneys, agents, and the public in general. 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.JOB CONDITIONS:Working Conditions: Normal office 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. Extended and/or non-standard hours 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
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