Claims Specialist III

Profile

Claims Specialist III
The candidate functions as a personal lines property claims specialist to evaluate, negotiate and bring to final resolution serious exposure large loss claims requiring investigation, liability evaluation and negotiation. Promotes and provides "On Your Side" customer service. Oversees control and supervision of suit files to conclusion and oversees the activities of defense counsel. Expedites settlement and control of average loss cost and litigation expense in compliance with best claims practices. Reports to Reports to Claims Manager. Promptly and effectively handles to conclusion assigned claims with little to no direction and oversight which 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. Accurately pays claims based on policy provisions, state mandates and/or fee schedules. 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. Opens, closes and adjusts reserves in accordance with company practices designed to ensure reserve adequacy. Recommends Special Reserves where necessary. Maintains current knowledge of: court decisions which may impact 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. Maintains current knowledge of local industry repair procedures and local market pricing. Serves as a mentor to less experienced claims associates and assists with training/presentations as assigned by claims management. Creates and analyzes severe incident reports, reinsurance reports and other information to home office, claims management, and underwriting. Partners with SIU and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for suit, trial, or subrogation. (Property/MD/Casualty). Manages or prepares files for suit, trial or subrogation. Consults claims staff and defense counsel for discovery processes, suit file/trial strategy as related to case-specific issues. Initiates and conducts follow-ups via proficient use of the claims systems and other related business systems. Delivers a positive On-Your-Side customer service experience to all internal, external, current and prospective Nationwide customers. Able to act for the Claims Manager; provides leadership to less experienced claims associates; provides one-on-one training. Other duties as assigned.

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