Nationwide Field Claims Specialist, Private Client (NY Tri-State Area - Philadelphia, NY, NJ) in New York, New York

#claims

*Candidate must be physically located in the Tri State NY region. Travel will be involved and individual must be accessible to New York City, Philadelphia and greater New Jersey.

*Successful candidate will be experienced in large loss claims handling with complexity. Must be self-driven with the ability to work well autonomously.

JOB SUMMARY: Investigates claims that may include a combination of Casualty, Material Damage and/or Property for Personal/Commercial Lines as assigned to reach settlements within limits of authority. Manages moderate personal lines property losses (structure and contents) from $0 to $100K while maintaining high member engagement. Promotes and provides Crestbrook customer service. Work may be handled by personal contact, telephone or through correspondence. Handles claims with limited supervision

REPORTING RELATIONSHIPS: Reports to Claims Manager

CORE JOB DUTIES & RESPONSIBILITIES:

  • Conducts onsite field investigations and/or field re-inspections of moderate exposure personal lines claims and coordinates rebuilding of damages with contractors, various trades and architects. Supports and partners with SIC and NWI on Personal/Commercial losses for field inspections. Participates in litigated and non-litigated claims.

  • Completes onsite Xactimate estimates, thorough investigations, photos, and narrative reports. Obtains medical reports, appraisals, estimates of property damage and evaluates bodily injury claims as needed. When necessary will be required to coordinate and review work performed by vendors.

  • Determines liability and documents the claim file by obtaining data from interviews with persons associated with the case, recorded statements, and police reports.

  • Accurately pays claims based on policy provisions, state mandates and/or fee schedules. Authorizes and/or approves all claim payments within granted authority associated with the claim, which may include litigation expense.

  • Opens, closes and adjusts reserves in accordance with company practices designed to ensure reserve adequacy. Recommends Special Reserves where necessary.

  • Partners with SIU and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for suit, trial, or subrogation. (Property/MD/Casualty)

  • Prepares/reviews reservation of rights, non-waiver agreements and denials of coverage when appropriate

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

  • Delivers a positive Crestbrook customer service experience to all internal, external, current and prospective Nationwide customers.

  • Performs other duties as assigned.

MINIMUM JOB REQUIREMENTS:

Education: Undergraduate degree or equivalent experience preferred.

License/Certification/Designation: State licensing where required.

Experience: Three to Five years successful experience in customer service and/or claims handling required. Multi-line or discipline experience preferred.

Knowledge: General knowledge of insurance theory and practices, and contracts and their application. Property estimating and automated claims systems. Proven knowledge of the investigation, negotiation and settlement activities used to resolve extensive property damage claims.

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 and problem solving skills necessary to make decisions and resolve conflict in such areas as application of coverage’s to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions. Ability to establish repair requirements and cost estimates for property losses. Organizational skills to effectively prioritize work. Command of written and verbal communication skills for contact and/or negotiation with policyholders, claimants, repairpersons, attorneys, agents and the public. Ability to efficiently operate a personal computer and related 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 the: hiring manager’s leader and HRBP.

JOB CONDITIONS:

Overtime Eligibility: Not Eligible (Exempt)

Working Conditions: Normal office or field claims environment. May require ability to sit and operate telephone and personal computer for extended periods. 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 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). Extended and/or non-standard hours as required.

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 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.

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