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Job Summary
The Claims Casualty Adjuster handles low to moderate-complexity claims involving material damage, property, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include liability investigation, coverage evaluation and negotiation of low to moderate-complexity claims in compliance with established company technical and customer service Best Practices. Under moderate supervision, works within specific limits of authority to resolve claims with well-defined procedures.
Job Duties
- Communicate and interact with a variety of individuals including insureds and claimants. Explain benefits, coverages, fault and claims process either verbally or in writing in compliance with regulatory and statutory requirements. Recognize and appropriately address common coverage issues.
- Conduct phone and/or field investigations to determine liability and damages. May attend and participate in legal proceedings. Identify and obtain statements from insureds, claimants and witnesses.
- Evaluate and determine claim values upon receipt and assessment of property, bodily injury and liability data.
- Negotiate within settlement authority with insureds and claimants to resolve their first and third party claims.
- Handle administrative functions, update database production reports, and document and update claim files via company systems, i.e. CACS, HUON, HOC, GUIDEWIRE, etc.
- Verify and interpret/resolve coverage by gathering necessary information to ensure policy applicability. Coordinate with internal and external departments as required.
- Independently resolve claim exposures within level of authority.
- Respond quickly to customer needs and problems.
Qualifications
- Bachelors Equivalent combination of education and experience Preferred
- 4-6 years Prior claims handling experience. Required
- 4-6 years Property or Casualty claims administration experience. Preferred
- Working knowledge of claims best practices and procedures.
- Moderate understanding of building and vehicle repair practices.
- General knowledge of insurance, fault assessment, negligence and subrogation principles.
- Working knowledge of Microsoft Office suite, general computer software and claims software.
- Advanced organization and planning recognition skills required.
- Advanced oral and written communication skills required.
- Advanced interpersonal skills required.
- Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required
- Associate in Claims - Insurance Institute of America Preferred
- An insurance/claims adjuster license may be required for claims administration in specific states. Preferred
Scope
- Work is accomplished with limited direction. Determines and develops approach to solutions. Work is evaluated upon completion to ensure objectives have been met.
- Provides resolution to an assortment of problems that are typically well defined, but some clarification or judgment is required to determine action, as additional information about the problem/task is discovered. Uses judgment within defined practices/procedures to determine appropriate action. Problem/Task resolution timeframe: Inclusive of shorter timeframes, but the majority of tasks take up to several weeks to resolve.
- Under general supervision, proceeds alone for regular duties, referring questionable cases to supervisor.
- Individual Contributor
- Failure to achieve results or erroneous judgments may require the allocation of additional resources to correct and/or achieve goals.
- Contacts are primarily within the department or function with occasional cross-functional interfaces. Some limited external customer contact on routine matters.
Remarkable benefits:
•   Health coverage for medical, dental, vision
•   401(K) saving plan with company match AND Pension
•   Tuition assistance
•   PTO for community volunteer programs
•   Wellness program
•   Employee discounts (membership, insurance, travel, entertainment, services and more!)
"Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value.”
AAA is an Equal Opportunity Employer
