A $2,500 SIGN-ON BONUS will be given to all external candidates hired into this role. The bonus is paid in the first pay period after 30 days of employment. 

Ideal Candidate Fairfield County, CT

This is a work-from-home position with travel to policy locations (average 3-4 days a week). The selected individual must reside in the respective territory.

Candidates must have: Strong customer service competency

Ideal candidates will have:

• Xactimate experience
• Construction/Contractor experience - Residential Homes, HVAC, Roofing,
• Prior claims handling experience

(Internal Use Only) Compensation Grade: F3

Job Description Summary

No two property claims are ever the same and each customer has unique needs. Our team thrives on providing the very best service and building lasting, successful relationships with our customers. If you are confident, curious, driven to learn and grow, and have a desire to help people when they most need it, we want to know more about you!

As a Claims Specialist, you'll work to evaluate and resolve serious exposure, large loss claims requiring investigation, liability evaluation and negotiation. We'll count on you to expedite settlements and control average loss cost and litigation expense according to the best claims practices.

Job Description

Key Responsibilities:

• Handles all assigned claims promptly and effectively, with little direction and oversight, which may include complicated and catastrophic losses. Makes decisions within delegated authority, recommends settlement values in the disposition of claims as outlined in company policies and procedures. 

• Accurately pays claims based on policy provisions, state mandates and/or fee schedules.

• Determines proper policy coverages and applies standard methodologies to conclude assigned cases according to company guidelines. Adheres to high standards of professional conduct while delivering outstanding service.

• Opens, closes and adjusts reserves according to company practices to ensure reserve adequacy. 

• Maintains knowledge of court decisions that may affect the claim's function; current principles and practices; innovations; and policy changes and modifications. May be required to maintain knowledge of other functions within assigned subject area. This may require attending various seminars or training sessions.

• Maintains current knowledge of local industry repair procedures and local market pricing.

• Able to act for Claims Manager. Mentors and provides leadership to less experienced claims associates. Provides one-on-one training and assists with training/presentations as assigned by claims management.

• Creates and analyzes severe incident reports, reinsurance reports and other information to corporate office, claims management and underwriting.

• Partners with Special Investigation Unit and Subrogation to identify fraud and subrogation opportunities. Assist general counsel to prepares files for suit, trial or subrogation. 

• Consults claims staff and defense counsel for discovery processes and lawsuit file/trial strategy on case-specific issues.

• Initiates and conducts follow-ups through proficient use of the claims and other related business systems.

• Delivers an outstanding customer service experience to all internal, external, current and prospective Nationwide customers.

May perform other responsibilities as assigned .

Reporting Relationships: Reports to Claims Manager. Individual contributor role.

Typical Skills and Experiences:

Education: Undergraduate degree or equivalent experience preferred. Advanced degrees in law or related field desirable. 

License/Certification/Designation: Successful completion of required claims certification schools/courses. Professional development such as IIA or CPCU preferred. State licensing where required. 

Experience: Five years of experience handling property claims, insurance processing or field claims adjusting. 

Knowledge, Abilities and Skills: Demonstrated knowledge of insurance theory and practices, insurance contracts and their application. Sophisticated knowledge of property claims standard methodologies and the legal aspects of court procedures affecting legal liability for all lines of insurance.

Excellent customer service skills and confirmed ability to meet customer needs and provide exemplary meaningful service by advising customers of the claims process and ensuring a positive customer experience. Demonstrated analytical skills needed to make decisions and resolve issues related to the application of coverage to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions. Validated ability to establish repair requirements and cost estimates for extensive property damage losses and serves as a subject matter authority on respective claims projects. Proven organizational skills to effectively prioritize increased and sophisticated workloads. Demonstrates strong but flexible standards and be balanced based on the conflicting demands of the position. Excellent written and verbal communication skills necessary to effectively communicate and/or advise policyholders, claimants, repair persons, attorneys, agents, and general public. Demonstrated leadership capabilities to effectively train, mentor and provide feedback to less experienced associates. Ability to operate personal computer with proficient use of claims and business software. 

Other criteria, including leadership skills, competencies and experiences may take precedence.

Staffing exceptions to the above must be approved by the hiring manager’s leader and HR Business Partner.

Values: Regularly and consistently demonstrates the Nationwide Values. 

Job Conditions:

Overtime Eligibility: Not Eligible (Exempt)

Working Conditions: Normal office or field claims environment. Able to make physical inspections of property loss sites; climb ladders, balance at various heights, stoop and bend and/or crawl to inspect vehicles and structures; work outside 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). Extended and/or non-standard hours as required. Must have a valid driver’s license with satisfactory driving record in accordance with Nationwide standards. 

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. 

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.