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Nationwide Insurance, founded in 1926, is one of the oldest and most well-respected insurance agencies in the United States. Headquartered in Columbus, Ohio, where more than 10,000
Claims Specialist III, Commercial Casualty
Location
United States + 1 moreAll locations: United States | Georgia
Posted
100 days ago
Salary
$88K - $132K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Claims Specialist III, Commercial Casualty
Nationwide Insurance
If you’re passionate about helping people protect what matters most to them at a Fortune 100 company with nearly $70 billion in annual sales, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers and partners are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. Job Description Summary Do you have a strong desire to resolve insurance claims by providing prompt, courteous and fair service to customers? Are you a skilled investigator, negotiator and communicator? If you thrive in an environment where you can problem-solve claims resolution, while following processes that provide fair resolution, customer satisfaction and cost management, then we want to hear from you! As a Claims Specialist, you’ll work to resolve commercial bodily injury and/or property damage claims of a serious and sometimes complex nature. We’ll count on you to promote and provide exemplary customer service. You’ll work to adjust serious exposure commercial casualty claims requiring investigation, property damage evaluation and negotiation. You’ll handle lawsuit files to conclusion and oversee the activities of defense counsel. You’ll also be responsible for handling claims according to prescribed authorization. Job Description Key Responsibilities: - Responsible for assigned claims, which may include complex and catastrophic casualty losses, with little to no direction and oversight. Makes decisions within delegated authority, recommends settlement values in the disposition of claims as outlined in company policies and procedures. Adheres to high standards of professional conduct consistent with the delivery of superior service. - Utilizes various methods of settlement in those cases where warranted; assigns cases to outside vendors as warranted. - Opens, closes and adjusts reserves in alignment with company practices designed to ensure reserve adequacy. Recommends special reserves where necessary, per company guidelines. Adheres to file conferencing notification and authority procedures. - Maintains current knowledge of: assigned insurance lines; 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 or training session - Mentors less experienced claims associates and assists with training/presentations as assigned by claims management. - Partners with Special Investigative Unit (SIU) and Subrogation to identify fraud and subrogation opportunities. Assists or prepares files for lawsuit, trial, or subrogation. (property/MD/casualty). - Oversees defense counsel in all lawsuit activities throughout the life of the claim. - Delivers a positive customer service experience to all internal, external, current and prospective Nationwide customers. May perform other responsibilities as assigned. Reporting Relationships: Reports to Claims Manager. Direct and indirect reports not typically assigned. Typical Skills and Experiences: Education: Undergraduate studies in business administration or related field preferred or relevant experience. 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 commercial casualty claims handling experience preferred. Knowledge, Abilities and Skills: Proven knowledge of medical, legal and/or commercial claims terminology, state regulations, claims processes, best practices, and customer relationship management. Advanced knowledge of insurance theory and practices, insurance contracts and their application. Excellent customer focus and proven ability to proactively meet customer needs. Analytical skills necessary to make decisions and resolve conflict in application of coverage, laws of jurisdiction to investigation facts, policy exclusions and exceptions. Organizational skills to effectively prioritize increased and more complex workloads. Demonstrates strong standards and flexibility to balance the conflicting demands of the position. Excellent written and verbal communication skills necessary to effectively communicate and/or negotiate with various audiences. Demonstrated leadership capabilities to effectively train, coach, and provide feedback to less experienced associates. Knowledge of claims systems. Advanced knowledge of claims best claims practices used to resolve serious and/or high exposure/large loss commercial claims. 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 used to make independent decisions and resolve conflict. Ability to coordinate with defense counsel in cases involving serious and sometimes complex commercial property damage issues from inception through trial. 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 personal computer and related software. Other criteria, including leadership skills, competencies and experiences may take precedence. Staffing exceptions to the above must be approved by the business unit executive and HR Business Partner. Values: Regularly and consistently demonstrates the Nationwide Values. Job Conditions: Overtime Eligibility: Exempt (Not Eligible) 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 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). 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. We currently anticipate accepting applications until 04/23/2026. However, we encourage early submissions, as the posting may close sooner if a strong candidate slate is identified before the deadline. Benefits We have an array of benefits to fit your needs, including: medical/dental/vision, life insurance, short and long term disability coverage, paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date, nine paid holidays, 8 hours of Lifetime paid time off, 8 hours of Unity Day paid time off, 401(k) with company match, company-paid pension plan, business casual attire, and more. To learn more about the benefits we offer, click here. Nationwide is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive culture where everyone feels challenged, appreciated, respected and engaged. Nationwide prohibits discrimination and harassment and affords equal employment opportunities to employees and applicants without regard to any characteristic (or classification) protected by applicable law. This position could be filled within any of the lower 48 U.S. states. Smoke-Free Iowa Statement: Nationwide Mutual Insurance Company, its affiliates and subsidiaries comply with the Iowa Smokefree Air Act. Smoking is prohibited in all enclosed areas on or around company premises as well as company issued vehicles. The company offers designated smoking areas in which smoking is permitted at each individual location. The Act prohibits retaliation for reporting complaints or violations. For more information on the Iowa Smokefree Air Act, individuals may contact the Smokefree Air Act Helpline at 888-944-2247. For NY residents please review the following state law information: Notice of Employee Rights, Protections, and Obligations LS740 (ny.gov) https://dol.ny.gov/system/files/documents/2022/02/ls740_1.pdf NOTE TO EMPLOYMENT AGENCIES: We value the partnerships we have built with our preferred vendors. Nationwide does not accept unsolicited resumes from employment agencies. All resumes submitted by employment agencies directly to any Nationwide employee or hiring manager in any form without a signed Nationwide Client Services Agreement on file and search engagement for that position will be deemed unsolicited in nature. No fee will be paid in the event the candidate is subsequently hired as a result of the referral or through other means. Nationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. If a Sales job, Sales Incentives, based on performance goals are possible in addition to this range. Note on Compensation for Part-Time Roles: Please be aware that the salary ranges listed below reflect full-time compensation. Actual compensation may be prorated based on the number of hours worked relative to a full-time schedule. The national salary range for Claims Specialist III, Commercial Casualty : $88,000.00-$164,000.00 The expected starting salary range for Claims Specialist III, Commercial Casualty : $88,000.00 - $132,000.00
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NTT DATANTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers and application services. Our consulting and industry solutions help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have experts in more than 50 countries. We also offer clients access to a robust ecosystem of innovation centers as well as established and start-up partners. NTT DATA is a part of NTT Group, which invests over $3 billion each year in R&D.
"NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible for: • Processing of Professional claim forms files by provider • Reviewing the policies and benefits • Comply with company regulations regarding HIPAA, confidentiality, and PHI • Abide with the timelines to complete compliance training of NTT Data/Client • Work independently to research, review and act on the claims • Prioritize work and adjudicate claims as per turnaround time/SLAs • Ensure claims are adjudicated as per clients defined workflows, guidelines • Sustaining and meeting the client productivity/quality targets to avoid penalties • Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. • Timely response and resolution of claims received via emails as priority work • Correctly calculate claims payable amount using applicable methodology/ fee schedule Requirements: • 3 year(s) hands-on experience in Healthcare Claims Processing • 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools • High school diploma or GED. • Previously performing – in P&Q work environment; work from queue; remotely • Key board skills and computer familiarity – o Toggling back and forth between screens/can you navigate multiple systems. o Working knowledge of MS office products – Outlook, MS Word and MS-Excel. Preferred Skills & Experiences: • Amisys • Ability to communicate (oral/written) effectively in a professional office setting • Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities • Time management with the ability to cope in a complex, changing environment"
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Customer and attorney communication will take place through different channels, including voice calls, email, and text messages. Through the utilization of innovative platforms and tools, you will engage in negotiation processes to reach fair injury settlements with all parties involved. Allstate Benefits Being a part of Allstate means you receive a benefits package from Day 1 of employment. This includes time off, healthcare, retirement, and more. That is why as an Allstater, you’ll enjoy a Total Rewards package that includes: - Competitive pay with needed support for continuous development and career advancement. - Flexibility in scheduling and a time off policy that helps support your work/life balance. - Initial and ongoing training to get you proficient in your new role - Comprehensive benefits like a 401K/pension, education reimbursement, and programs to help you balance work with the rest of your life. Visit www.allstategoodlife.com to learn more. 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Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component. For jobs in San Francisco, please click “here” for information regarding the San Francisco Fair Chance Ordinance. For jobs in Los Angeles, please click “here” for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance. To view the “EEO Know Your Rights” poster click “here”. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs. To view the FMLA poster, click “here”. 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