Claims Customer Service Representative II [United States]

 

If you’re passionate about helping people protect what matters most to them, 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!

Pay band C2.

Position based in Scottsdale, AZ.

Job Description Summary

Do you thrive in a work environment where you can deliver exceptional customer service? Are you an outstanding communicator who can work independently and as part of a team? If you can diagnose and solve complex insurance situations and find solutions to address out of the ordinary challenges, then we want to hear from you!

As a Claims Customer Service Representative II, you can be the first point of contact with customers. Making a great impression is important to creating and maintaining good relationships. In this role, you'll addresses complex personal lines claims and works with policyholders, claimants, agents and others by phone, email, text and chat.

Job Description

Key Responsibilities:

• Provides customer service contact for claims reporting activity. Employs claims call center standard methodologies in all activities.
• Creates loss reports by securing information from policyholders, claimants, agents, and other parties. Establishes the claim master record by direct entry of claim data via computerized claim system. Takes manual loss reports as necessary.
• Verifies coverage under various policies or policy provisions based on variances of state, jurisdiction and regulatory requirement.
• Makes direct assignments to inside or field claims adjustment personnel after taking notice of loss. In the absence of the supervisor, assigns claims of other claims service representatives within established guidelines and procedures.
• Refers claimants to preferred repair shops or schedules drive-in appointments as appropriate.
• Handles inquiries from policyholders, claimants and others as appropriate.
• Establishes and maintains a follow-up system for completion of incomplete claim reports. Proactively contacts policyholders/claimants for additional information to expedite proper handling of claims.
• Maintains, records and reports information.
• Handles customer service complaint situations as appropriate, or provides information for resolution.
• Creates and maintains information screens. Inputs data into personal computer-based software as required.
• Handles coverage verification with other appropriate functions for all state operations when circumstances do not allow a claim to be established on the system. This would include the verification of assigned risk as well as voluntary policy information.
• Provides technical advice to claims service representatives on personal and commercial lines policy coverage in the absence of a supervisor.

May perform other responsibilities as assigned.

Reporting Relationships: Reports to Supervisor.

Typical Skills and Experiences:

Education: High school studies. Post-high school studies or insurance industry coursework preferred.

Experience: Claims Service Representative I experience preferred and successful completion of formal and on-the-job training.

Knowledge, Abilities and Skills: Extensive knowledge of the duties and responsibilities of the claims service representatives with proven performance as indicated in quality program results. Superior knowledge of claims processing system(s) and the claims reporting process, as well as detailed knowledge of insurance coverage, policies and claims handling procedures. Ability to make decisions such as the application of coverage, assignments and work priorities. Outstanding verbal and written communication skills needed to effectively interact with the policyholders, claimants, agents and co-workers. Ability to efficiently operate personal computer and all related claims/business software. Some positions provide service primarily for customers speaking a language other than English. These positions may require skills specific to the language and culture, including bilingual skills.

Other criteria, including leadership skills, competencies and experiences may take precedence.

Staffing exceptions to the above must be approved by the hiring manager's leader and HR Business Partner.

Values: Regularly and consistently demonstrates Nationwide Values.

Job Conditions:

Overtime Eligibility: Eligible (Non Exempt)

Working Conditions: Claims call center may be 7/24/365 environment. Prolonged periods of sitting at personal computer and extensive use of keyboard while taking telephone calls; must use a telephone headset. Non-standard hours possible; overtime as required. Able to work catastrophes (CAT) as needed.

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: A valid credit and/or background check may be required as part of the selection process in locations where a state department of insurance license is required for the position.

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,

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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.

 

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