Evaluates all pertinent information and works in conjunction with claimant/client to pursue most appropriate claims resolution.
Manages litigated claim issues in alignment with Best Claims Practices. Obtains appropriate litigation budgets and develops appropriate power of attorney in partnership with counsel. Manages litigation expenses of Nationwide Trial Division or approved outside counsel.
Manages assigned claims with little to no direction and oversight. Makes decisions within delegated authority as outlined in company policies and procedures. Adheres to high standards of professional conduct consistent with the delivery of superior service.
Submits severe incident reports, reinsurance reports and other information to home office, claims management, and underwriting.
Partners with Special Investigative Unit (SIU) and Subrogation to identify fraud and subrogation opportunities.
Delivers a positive customer service experience to all internal, external, current and prospective Nationwide customers.
May periodically conduct customer/account visits to review reserves and discuss status of significant claims. May also present educational workshops to client personnel.
May perform other responsibilities as assigned.
Reporting Relationships : Reports to Supervisor/Manager. No direct or indirect reports.
Typical Skills and Experiences :
Education: Undergraduate studies in business administration or related field preferred and/or relevant Workers' Compensation experience.
License/Certificati
Benefits
Vision insurance
Additional Information
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 provide 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 workers' compensation 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 investigate and handle medical and/or loss-of-time workers compensation claims from multiple states to determine compensability, entitled benefits, average weekly wage and benefit rate according to applicable state workers' compensation statute. We'll count on you to promote and provide exemplary customer service. Key to success will be your ability to establish timely and appropriate case reserves aligned with Best Practices and manage claims to appropriate resolution. You'll also communicate frequently with customers, injured workers and medical providers.
Job Description
Nationwide · Remote