#claims
***This is a Personal Lines Property position
Five years of personal lines property or commercial property claims experience required
Advanced degrees in law or related discipline desirable, but not required
Preferred locations are Columbus, OH or Des Moines, IA
JOB SUMMARY: Conducts personal lines claims technical file reviews and/or re-inspections, calibration and audits. Serves as a technical resource and expert in the review and evaluation of personal lines claims files in accordance with established policies and procedures. Provides specialized claims training in accordance with ongoing training and developmental needs. Performs quality re-reviews and calibration functions to ensure file adequacy and the measurement of loss cost opportunities in accordance with and support of best claim practices and On Your Side Service. Provides personal lines technical and training support to claims operations, assisting in identifying performance trends and in implementing performance improvement initiatives. Advises claims leadership on technical trends based on objective findings.
RELATIONSHIP: Reports to Reports to Manager; no direct reports
JOB RESPONSIBILITIES:
1. Promptly and effectively handles to conclusion assigned claims with little to no direction and oversight that may include complex and catastrophic casualty losses. Promptly and effectively handles to conclusion all assigned claims with little to no direction and oversight. 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. Conducts closed and/or open file reviews/re-inspections/calibration and audits for the purpose of compiling skill adequacy and lost cost opportunity results. Identifies and communicates trends for claims managers and leaders.
3. Opens, closes and adjusts reserves in accordance with company practices designed to ensure reserve adequacy. Recommends Special Reserves where necessary.
4. Maintains current knowledge of: court decisions that may affect the claims function; current principles and practices in the claims function; material damage techniques and repair technology innovations; and policy changes and modifications. May be required to maintain knowledge of other functions within assigned discipline. This may require attendance at various seminars or training sessions.
5. Serves as a mentor to less experienced claims associates and assists with training/presentations as assigned by claims management.
6. Provides technical file review training and support to other review associates as assigned.
7. Acts as a technical resource by providing input and support to claims leadership regarding claims performance and utilization of the quality audit process.
8. Creates and analyzes severe incident reports, reinsurance reports and other information to home office, claims management, and underwriting.
9. Maintains a high level of calibration proficiency in team/review calibration exercises.
10. Partners with SIU and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for suit, trial, or subrogation. (Property/Casualty/MD).
11. Consults with claims staff and defense counsel for discovery processes, suit file/trial strategy as related to case-specific issues.
12. Proficiently identifies and analyzes file review results and performance opportunities for the development of and assistance in implementation of action plans.
13. Delivers a positive On-Your-Side customer service experience to internal, external, current and prospective Nationwide customers.
14. Other duties as assigned.
JOB REQUIREMENTS:
Education: Undergraduate degree or equivalent experience preferred. Advanced degrees in law or related discipline desirable.
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 of personal lines property and/or casualty, and/or material damage claims experience in progressively more technical/complex claims positions. Experienced in use of computer based estimating software and experience interpreting estimates using unit pricing.
Knowledge: Requires advanced knowledge of claims best practices, technical claims operations, procedures and claims performance strategies, day-to-day claims operations, as well as Claims Best Practices. Requires advanced knowledge of claims operating practices, and claims litigation laws and regulations. Personal lines liability, and/or property policy knowledge/analysis required. Proven knowledge of insurance theory and practices, insurance contracts and their application. Advanced knowledge of casualty claims best practices, medical terminology and the legal aspects of court procedures affecting legal liability for all lines of insurance. 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. Ability to establish repair requirements and cost estimates for extensive losses and serves as a subject matter expert on respective claims projects. 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.
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. Proven analytical skills necessary to make decisions and resolve conflict in such areas as application of coverage to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions. Proven ability to establish repair requirements and cost estimates for extensive material damage losses and serves as a subject matter expert on respective claims projects. Proven organizational skills to effectively prioritize increased and more complex workloads. Demonstrates strong but flexible standards and can act different, 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 policyholders, claimants, repair persons, attorneys, agents, and general public. Demonstrated leadership capabilities to effectively train, coach, and provide feedback to less experienced associates. Proven ability to operate personal computer with proficient use of claims and business 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.
JOB CONDITIONS:
Working Conditions: Normal office environment or remote office environment. May require ability to sit and operate 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 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. Ability to work extended 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 Family/Function: CLM/CLQ
Job Evaluation Activity: Revised 8/2012 KLG
123IND