Processor II, Claims Services - E&S​/Specialty

Processor II, Claims Services - E&S/Specialty

Join to apply for the Processor II, Claims Services - E&S/Specialty role at Nationwide.

Nationwide Cavasson Campus in North Scottsdale (Hayden & 101). Remote work will NOT be considered for this opportunity due to the on-site processing required for this role.

Exceptional processing is essential to accurate claim resolution. We work in a fast‑paced, interactive environment where outstanding customer service is valued. If you have a Lean approach as well as a desire to innovate and apply your technical knowledge and skills, we want to know more about you!

• Responsible for the most complex claims processing functions including open items, ESCHEAT, collections, deductible billings, reports analysis, erroneous claims and manual checks, and claims account reconciliation. Also may perform the duties of a Claims Processor as requested.
• Effectively uses all related systems such as Class Plus, Claims Processing System (CPS), Nationwide Auto Processing System (NAPS), Fire Processing System (FPS), stand‑alone PC, Wausau and others.
• Assists in determining the effect of new releases, transmittals, procedures and suggestions.
• Quality checks team member work; assists in the training of new employees and cross‑training for current employees on input processing, statistical reporting, and other claims processing tasks.
• Prepares unit statistical report, reconciles reports, verifies commercial coverages, handles small first party claims, and sets up Comparative Rater (CR) policies on appropriate system.
• Researches and documents projects to systems concerning program errors, processing enhancements, or workflow issues at the direction of the group leader, team leader or manager.
• Assists state or company auditors, as requested.

May Perform Other Responsibilities As Assigned.

Reporting Relationships:
Reports to Lead or Supervisor.

Education: High school studies. Completion of formal customer service or accounting class or seminar preferred.

Experience: Two years experience as a Claims Services Processor, or four years related insurance, accounting or service preferred.

Knowledge, Abilities and

Skills:

Claims processing systems including Class Plus, CPS, NAPS and FPS; coding practices and procedures, including manual claims. Interrelationship between claims services and other departments. General accounting practices as they relate to open item processing. Customer service concepts. Verbal and written communication skills to interact with internal/external contacts including claims representatives, agents, policyholders/claimants, other departments/functions; ability to read and interpret manuals and reference materials.

Ability to research, analyze and resolve complex claims processing and open item issues. Ability to operate personal computer and related processing software; operate business machines and calculator (ability to pass applicable data entry/typing test). Prioritize own work; determine whether any adverse information is present that would require claims review using established criteria, guidelines, and standards.

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

Staffing Exceptions to the above Typical Education and Experience must be approved by the hiring manager’s leader and HR Business Partner.

Values: Regularly and consistently demonstrates Nationwide Values.

Overtime Eligibility: Eligible (Non Exempt)

Working Conditions: Normal office environment. Extended hours sitting at personal computer. Requires ability and availability to work non‑standard or extended hours, overtime or shifts as assigned to support a 24/7/365 claims or claims call center environment. Ability to lift and carry up to 25 pounds on a regular basis (claims files).

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: Due to the fiduciary accountabilities…