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Job Summary
This position supports the Property Claims operation by handling claims reported on Homeowner policies written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The position handles claims of moderate to high complexity. The primary functions include interpreting information from First Notice of Loss reports, claim investigation, coverage evaluation, negotiation strategies and claims resolution. Employs discretion and independent judgment to ensure compliance with state and federal laws. Applies technical and customer service best practices in accordance with company guidelines.
Job Duties
Identify and obtain statements from insureds, vendors and witnesses. Conduct phone investigations to determine coverage and damages and differentiate between allegations and facts in each loss. Determine policy obligations by assessing the liability and damage components of the loss. Responsible for maintaining proper activities and service levels.
Communicate and interact with a variety of individuals. Explain policy coverages, benefits, and claims process either verbally and/or in writing which complies with regulatory and statutory requirements. Recognize and appropriately address moderate-complexity coverage issues.
Evaluate, assess, make decisions, and negotiate within settlement authority with insureds to resolve first-party claims in multiple markets. Demonstrate proficiency with assessment of personal property, property damage, loss of use, and claims technology and tool usage. Objectively discern and address issues that may be questioned in an audit.
Coordinate with internal and external departments as required.
The position requires a higher degree of discretion and independent judgment in analysis and problem-solving to manage losses effectively. Respond quickly and effectively to customer needs and problems.
May attend and participate in legal proceedings.
Qualifications
Bachelors Equivalent combination of education and experience
4-6 years Prior claims handling experience. Required
4-6 years Property claims administration experience. Preferred
Working knowledge of claims administration best practices and procedures.
Moderate knowledge of fault assessment, negligence and subrogation principles required.
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
An insurance/claims adjuster license may be required for claims administration in specific states.
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.
Plans and arranges own work, refers only unusual cases to supervisors or others.
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
