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Monster Sourcing Services
Job Reference Code
Insurance Claims Representative
About the Job
JOB SUMMARY: Investigates, evaluates, negotiates and brings to a final resolution commercial property damage claims predominantly of a moderate to serious nature. Promotes and provides ""On Your Side"" customer service. Responsible for the handling of claims in accordance with prescribed authorization.
JOB RESPONSIBILITIES: 1. Handles to conclusion moderate to serious complexity commercial property damage claims with little to no direction and oversight. Makes decisions within delegated authorization; recommends settlement values in the disposition of moderate and sometimes serious and complex claims. Adheres to high standards of professional conduct while providing delivery of superior claims service. 2. 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. 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 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. 5. Maintains current knowledge of local industry repair procedures and local market pricing. 6. Submits severe incident reports, reinsurance reports and other information to claims management as needed. 7. Partners with SIU and Subrogation to identify fraud and subrogation opportunities. 8. Delivers a positive On-Your-Side customer service experience to all internal, external, current and prospective Nationwide customers. 9. Serves as a mentor to less experienced claims associates and assists with training/presentations as assigned by claims management. 10. Other duties as assigned.
JOB REQUIREMENTS: Licenses/Designations: State licensing where required. Successful completion of required/applicable claims certification training/classes. Experience: One to three years property claims handling experience, with at least two years commercial property claims preferred. Knowledge: Demonstrated knowledge of best claims practices to resolve moderate to severe property claims. 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 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. Ability to successfully negotiate commercial property claims of moderate to serious nature. Command of written and verbal communication skills for contact and/or negotiation. Organizational skills to effectively establish work priorities in accordance with Best Claims Practices. Ability to operate a PC and related 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.