Claims Spec II, Coml Casualty

Company Name:
This position will be staffed in the Harleysville, PA office, supporting the Harleysville Commercial Casualty Claims Department.
Prior casualty claims experience is required.
This position may be staffed at another level, based on experience and/or qualifications.
JOB SUMMARY: Handles to conclusion moderate to serious commercial bodily injury and/or property damage claims. Promotes and provides ""On Your Side"" customer service. Makes decisions within maximum 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.
RELATIONSHIP: Reports to Reports to Claims Manager
1. Handles to conclusion commercial claims involving moderate to severe bodily injury and/or property damage with little to no direction and oversight. Makes decisions within delegated authorization; recommends settlement values in the disposition of moderate and sometimes severe 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.
Education: Undergraduate studies in business administration or related field preferred and/or relevant experience
Licenses/Designations: State licensing where required. Successful completion of required/applicable claims certification training/classes.
Experience: One to three years casualty claims handling experience, with at least two years commercial casualty claims preferred.
Knowledge: Demonstrated knowledge of best claims practices to resolve moderate to severe bodily injury and/or property claims. Knowledge of all lines of property/casualty insurance. 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.
Working Conditions: Inside or field claims environment. May require ability to sit and use 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 able to make physical inspections of accident scenes and property loss sites. Must be able to climb ladders, balance at various heights, stoop, bend and/or crawl to inspect vehicles and structures. Must be able to work out-of-doors in all types of weather. Must be willing to work irregular hours and to travel with possible overnight requirements. May be on-call. Must be available to work catastrophes (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 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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