Insurance,Litigation/Attorney/In House/Indianapolis, Indiana Counsel Jobs in Indiana - 88258 | Submit Resume | General Counsel Consulting
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In House Legal Job Listings

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Insurance,Litigation/Attorney/In House/Indianapolis, Indiana
Refer job# ZDTG88258
 
Field Claims Specialist II, Case Bodily Injury Duties: Specializes in complex casualty claims. Adjusts serious exposure claims requiring investigation, liability evaluation and negotiation. Oversees control and supervision of suit files to conclusion and oversees the activities of defense counsel. Promotes and provides ""On Your Side"" customer service. Investigates and effectively resolves personal lines liability claims via telephone. Responsible for the disposition of claims in accordance with prescribed authority and according to best claims practices. Reports to Claims Manager. Promptly and effectively handles to conclusion all 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. Utilizes various methods of settlement in those cases where warranted; assigns cases to outside vendors as warranted. Appropriate use of structure settlement on all applicable cases. 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. 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. 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. Maintains current knowledge of local industry repair procedures and local market pricing. Submits severe incident reports, reinsurance reports and other information to claims management as needed. Partners with SIU and Subrogation to identify fraud and subrogation opportunities. Delivers a positive On-Your-Side customer service experience to all internal, external, current and prospective Nationwide customers. Serves as a mentor to less experienced claims associates and assists with training/presentations as assigned by claims management.

REQUIREMENTS: Undergraduate degree or equivalent experience preferred. Postgraduate studies in medical field or law desired. Successful completion of required claims certification schools/courses. 3-5 years' claims handling experience including experience handling complex bodily injury claims. Knowledge of insurance theory and practices, insurance contracts and their application. Knowledge of causality claims best practices, medical terminology and liability analysis preferred. Proven knowledge of insurance contracts, medical terminology and the legal aspects of court procedures affecting legal liability for all lines of insurance. Excellent customer focus and proven ability to proactively meet customer needs. Proven knowledge of insurance contracts, medical terminology, workers compensation, and the legal aspects of court procedures affecting legal liability for all lines of insurance. Knowledge of claims systems. Proven 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. Proven ability to establish repair requirements and cost estimates for extensive losses and serves as a subject matter expert on respective claims projects. Proven organizational skills to effectively prioritize increased and more complex workloads.Demonstrates strong but flexible standards and can act different, can be seen as balanced based on the conflicting demands of the position. Excellent written and verbal communication skills necessary to effectively communicate and/or negotiate with policyholders, claimants,attorneys, agents, and general public. Demonstrated leadership capabilities to effectively train, coach, and provide feedback to less experienced associates. 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; coordinate the handling of cases involving serious and sometimes complex liability issues. Exceptional oral and written communication skills for contract and negotiation with all policyholders, claimants, attorneys, physicians, agents and the general public. Ability to successfully negotiate casualty claims including the ability to interpret medial reports and legal reports. Organizational skills to effectively establish work priorities in accordance with best claims practices. Ability to operate a personal computer with proficient use of claims and business software.
 
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