Claims Consultant, Casualty - E&S/Specialty (Errors & Omissions, Professional Liability)

Nationwide Insurance; Pennsylvania; Remote; USD 80,000 - 100,000; Full time

Job summary

A leading insurance provider is seeking a Claims Consultant with over 8 years of experience in handling complex claims and E&O insurance. The role involves investigating and resolving high-severity claims, developing training plans, and maintaining relationships with key business partners. This position offers flexibility in location, including remote work options. Candidates should possess strong analytical skills and effective communication abilities.

Qualifications

• 8+ years of insurance experience preferred with a focus on handling complex claims.
• Experience in Professional Lines Liability and E&O claims is highly preferred.
• Ability to work independently and manage ambiguity.

Responsibilities

• Investigate, evaluate, and resolve complex claims and lawsuits.
• Develop training plans and strategies for divisional team members.
• Build and maintain relationships with general agency and internal business partners.

Skills

Claims handling experience

Analytical skills

Effective communication

Education

Undergraduate degree in insurance, business, or related fields

Advanced degree preferred

Job description

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! At Nationwide, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care.

Work Environment: The location of this position is flexible and open to virtual and/or remote based applicants.

What you can Expect: This position will support the Professional E&O with primary focus on Medical Malpractice, E&O Claims, and Employment Practices Liability.

The ideal candidate will have:

• 5+ years of Professional Lines Liability, E&O claims, and/or Medical Malpractice highly preferred.
• Reinsurance and carrier experience is preferred.
• Familiar with claims made and reported coverage forms.
• Litigation claims handling experience.
• Demonstrated coverage application experience.
• JD is a plus.

Job Description Summary

The Excess Surplus (E&S) Claims team handles some of the most unique and interesting insurance claims at Nationwide. Many have complicated risks and loss history, requiring us to be adaptable and resilient in our work to help customers. If you love a challenge and can apply outstanding organizational, investigative and communication skills to your work, we want to hear from you!

As a Claims Consultant, you'll primarily be responsible for investigating, evaluating and resolving commercial and professional lines claims and lawsuits of a more severe and complex nature, or from a specialty line or program of significant value to the organization. These claims files typically include litigation and complex coverage issues. In addition, you'll work with claims divisional managers and directors to develop training plans and strategies for the division. We'll count on you to coach, train and mentor individual team members. Building and maintaining positive relationships with general agency and internal business partners, major customers and key individuals is important, too.

Key Responsibilities:

• Resolves claims and lawsuits of a more severe and complex nature, or from a specialty line or program of significant value to the organization. Acts as a subject matter authority in a particular line of business or risk.
• Identifies technical training needs and develops action plans to meet those needs. May provide technical consultation/direction to all levels of claim professionals. Functions as a content specialist to assist in developing training curricula.
• Builds and maintains open and trusting working relationships with general agents, producers and key internal business partners.
• Evaluates claims, in a timely manner, to identify and manage reserves according to company standards and best reserving practices.
• Maintains current knowledge of multiple coverage lines, venue-specific court decisions which may impact the claim function, current guidelines in the claims function and policy changes and modifications. This may require attending various seminars and training sessions.
• Reviews and analyzes files to ensure adherence to Division guidelines and best claims handling practices. Reviews claims quality results to identify coverage trends and to ensure consistency in policy interpretation. Recommends training or other appropriate action.
• Provides consultation/direction to complex claims requiring the highest level of technical skill and expertise.
• Ensures appropriate attorney assignments, proper reserving, prompt and accurate reporting to reinsurance carriers, prompt and fair negotiations and adequate trial preparation, if necessary.
• Monitors litigation trends and claim handling practices to ensure lawsuits are handled in a consistent fashion. Maintains trial log for each line of business.
• May designs specific reservation of rights templates for use by technical associates across channels. Approves all reservations of rights, disclaimers, tender/rejection/acceptance letters.
• Provides claims handling expertise to new product development. Provides standardized processes for claims handling related to new products.

Typical Skills and Experiences:

Education: Undergraduate education in insurance, business, management, or related fields. Advanced degree preferred. Additional education in a particular line of business may be required by the hiring business unit.

License/Certification/Designation : Associates must acquire the required federal and/or state licenses/registrations within the time period designated by the business unit. Additional licenses/registrations may be required when new products and services are implemented. If an associate fails or is unable to acquire required licenses/registrations within the designated time period, the associate will be ineligible to continue in the position.

Completion of insurance courses such as IIA, AEI, or CPCU preferred.

Experience: Eight or more years prior insurance experience preferred. Proven experience handling higher severity and/or complex claims and litigation required. Proven experience analyzing and handling complex coverage issues. Specific experience in a particular line of business may be required by the hiring business unit.

Knowledge, Abilities and Skills: Proven knowledge of the best claims practices used to resolve severe claims practices. Confirmed knowledge in a particular line of business and/or additional education may be required by the business unit. Proven analytical skills to make independent decisions and resolve conflict in application of coverage to submitted claims, application of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions Much be able to effectively communicate and interact with other claim professionals in a leadership capacity. This includes the ability to maintain open and trusting working relationships while teaching, coaching and mentoring other claim professionals in a conscientious and empathetic manner. Ability to build and maintain open and trusting working relationships with insureds in order to gather pertinent information. Has the ability to effectively manage conflict and practices active listening. Ability to work independently and deal with ambiguity. Ability to present to all levels of management.

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.