Field Claims Spec II, Cas BI
Location: Houston, Texas
Description: Nationwide Mutual Insurance Company is at present looking to employ Field Claims Spec II, Cas BI right now, this job will be situated in Texas. More complete informations about this job opportunity kindly read the description below. **ADDITIONAL INFORMATION - PLEASE READ CAREFULLY**
The information between the asterisks contains specific information about this position while the informati! on after the asterisks contains general information about jobs in this job family at Nationwide.
- This position will be a work from home position that comes with a company vehicle. The selected candidate will support the Houston, TX territory. This position can be staffed at a different level depending upon the skills and background of the selected candidate.
- 3-5 years bodily injury claims adjusting experience
- Strong customer service skills
- Good problem solving skills
- Ability to work in ambiguous situations and learn on the fly
- Good negotiation skills
- Bilingual in Spanish is preferred
JOB SUMMARY: Specializes in complex casualty claims. Adjusts serious exposure claims requiring investigation, liability evaluation and negotiation. Oversees control and supervision of suit fi! les to conclusion and oversees the activities of defense couns! el. 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 Manager
DIRECT REPORTS: None
JOB RESPONSIBILITIES:
1. Promptly and effectively handles to conclusion all assigned claims with little to no 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. Utilizes various methods of settlement in those cases where warranted; assigns cases to outside vendors as warranted. Appropriate use of structure settlement on all applicable cases.
3. Determines proper policy coverages and applies best claims practices to conclude assigned! cases in accordance with company guidelines. Adheres to high standards of professional conduct while providing delivery of superior claims service.
4. 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.
5. Maintains current knowledge of insurance and applicable product/services; 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 and/or training sessions.
6. Maintains current knowledge of local industry repair procedures and local market pricing.
7. Submits severe incident reports, reinsurance reports and other information to claims management as needed.
8. Partners with SIU and Subrogation to identify fraud! and subrogation opportunities.
9. Delivers a positive On-Your-Side! customer service experience to all internal, external, current and prospective Nationwide customers.
10. Serves as a mentor to less experienced claims associates and assists with training/presentations as assigned by claims management.
11. Other duties as assigned.
JOB REQUIREMENTS:
Education: Undergraduate degree or equivalent experience preferred. Postgraduate studies in medical field or law desirable.
Licenses/Designations: Successful completion of required claims certification schools/courses.
Experience: Three to Five years claims handling experience including experience handling complex bodily injury claims.
Knowledge: Proven knowledge of insurance theory and practices, insurance contracts and their application. Advanced knowledge of causality claims best practices, medical terminology and liability analysis preferred. Proven knowledge of insurance contracts, 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. Proven knowledge of insurance contracts, medical terminology, workers compensation, and the legal aspects of court procedures affecting legal liability for all lines of insurance. Knowledge of claims systems. 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 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 t! o effectively communicate and/or negotiate with policyholders, claimants,attorneys, agents, and general public. 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. Analytical skills used to make independent decisions and resolve conflict; coordinate the handling of cases involving serious and sometimes complex liability issues. Exceptional oral and written communication skills for contract and negotiation with all policyholders, claimants, attorneys, physicians, agents and the general public. Ability to successfully negotiate casualty claims including the ability to interpret medial reports and legal reports. Organizational skills to effectively establish work priorities in accordance with best claims practices. Ability t! o operate a 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 Alternative Work Environment in local Claim Zone. 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 extended hours or 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 pr! incipal 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.
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If you were eligible to this job, please give us your resume, with salary requirements and a resume to Nationwide Mutual Insurance Company.
Interested on this job, just click on the Apply button, you will be redirected to the official website
This job will be opened on: Tue, 07 May 2013 02:48:30 GMT
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