Nationwide Columbus , OH 43216
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JOB SUMMARY: Reviews and determines disposition of first and third party claims.
Promotes and provides "On Your Side" customer service. Responsible for assigning claims to appropriate On Your Side Auto Repair Network (OYSARN) adjusters. Duties include taking inbound phone calls from members, customers, agents and repair facilities. Assist with pending claims management, sending regulatory letters and issuing payments.
REPORTING RELATIONSHIP: Reports to Reports to OYSARN Claims Manager or Supervisor
Reviews and determines payment of minor, undisputed, and/or limited authorization OYSARN claims. Assigns all other OYSARN claims to appropriate adjuster.
Verifies coverage and damage reports received from vendors and customers for accuracy and consistency with the claim as reported.
Audits bills for detection of possible fraud; refers findings to SIU as directed.
Remains current on requirements and legislation for assigned state(s).
Prepares and submits administrative reports as required.
Provides support for OYSARN unit claims associates and managers. Point of contact for internal/external customers.
Delivers a positive On-Your-Side customer service experience to all internal, external, current and prospective Nationwide customers.
Other duties as assigned.
Education: High school studies; some post high school course work preferred.
Licenses/Designations: State licensing where required
Experience: One year insurance, customer service and/or claims processing experience.
General knowledge of customer service principles and/or insurance processing activities and operational functions. Familiarity with claims policies and procedures preferred.
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.
Verbal and written skills to effectively communicate with policy holders, agents, and vendors. Ability to prioritize work and make sound decisions such as the application of coverages to submitted claims. Ability to work in a fast paced and team based environment.
Ability to perform basic mathematics to apply deductibles. Ability to use technical cost manuals. Ability to operate PC and related claims 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 Business Unit Executive and Human Resources.
Working Conditions: Normal office environment.
Requires prolonged periods of operating a personal computer. Extended and non-standard hours as required. CAT duty for this role will be performed inside a Nationwide location and not out in the field.
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.
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.
Job Evaluation Activity: Created 8/19/16 CSB
Additional Job Description
Job ID: 53216