Claims Complex Casualty Adjuster

Claims Complex Casualty Adjuster

The Claims Complex Casualty Adjuster handles complex 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, negotiation strategies and claims resolution of complex claims. Employs discretion and independent judgment to ensure compliance with state and federal law, and with established company, technical, and customer service best practices. Under limited supervision, works within specific limits of authority to resolve claims.

Job Duties

• 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.
• Communicate and interact with a variety of individuals including insureds and claimants. Explain benefits, coverages, fault and claims process either verbally or in writing which complies with regulatory and statutory requirements. Recognize and appropriately address complex coverage and subrogation issues.
• 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.
• Control expenses for areas of responsibility.
• Handle administrative functions, update database production reports, 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.
• Mentor other adjusters, assisting them with increasing understanding of adjudicating complex claims.
• Respond quickly to customer needs and problems.
• Independently resolve claim exposures within level of authority.

Qualifications

The starting pay range for this position is $90,400 -$120,300 annually.

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!)

Auto Club Enterprises is the largest federation of AAA clubs in the nation. We have 14,000 employees in 21 states helping 17 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity - we win. All of Us! With our national brand recognition, long-standing reputation since 1902, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

"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

Required

Preferred

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