This position handles moderate to complex claims matters involving homeowner property insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include investigation, damages evaluation, negotiation strategies, and claims resolution of moderate to complex claims. The position employs discretion and independent judgment to ensure compliance with state and federal law and established company Best Practices.
Job Duties
Identify and obtain statements from insureds, vendors and witnesses. Conduct phone and/or field investigations to determine coverage and damages and differentiate between allegations and facts in each loss.
Communicate and interact with a variety of individuals. Explain benefits, coverages, and claims process either verbally or in writing in compliance with regulatory and statutory requirements. Recognize and appropriately address moderate complexity coverage issues.
Evaluate and determine claim values upon receipt and assessment of property damage data.
Negotiate within settlement authority with insureds to resolve first claims.
Update database production reports, and document and update claim files via company systems, i.e. CACS, HUON, HOC, GUIDEWIRE, etc.
Control expenses for areas of responsibility.
Verify and interpret / resolve coverage by gathering necessary information to ensure policy applicability. Objectively discern and address issues that may be questioned in audit. Coordinate with internal and external departments as required.
May attend and participate in legal proceedings.
Respond quickly and effectively to customer needs and problems.
Qualifications
Bachelors Equivalent combination of education and experience
4-6 years Prior claims handling experience. Required
4-6 years Property claims administration experience. Preferred
1-3 years Experience in the construction industry. Preferred
Working knowledge of claims administration best practices and procedures.
Moderate knowledge of insurance, fault assessment, negligence and subrogation principles required.
Comprehensive understanding of vehicle and building repair procedures and third-party liability issues.
Working knowledge of Microsoft Office suite, general computer software and claims software.
Moderate leadership skills necessary.
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.
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