Casualty Claim Specialist - Florida

AAA-The Auto Club Group•FL-ACG Florida AOB, FL

2d•$70,000 - $80,000•Hybrid

About The Position

The Casualty Claim Specialist is a pre-litigation bodily injury adjuster responsible for investigating, evaluating, negotiating, and resolving bodily injury claims before litigation. The role manages a dynamic caseload, makes informed claim decisions, and works proactively with customers and other affected parties to achieve appropriate claim outcomes. The position is hybrid in Tampa, Florida, and the employee must reside within 50 miles of Tampa. The scheduled hours are Monday through Friday, 8:00 a.m. to 5:00 p.m. ET. The specialist reviews assigned claims; contacts insureds and other affected parties; explains expectations for the claim process; and documents activity in the claim-handling system. The role includes complex coverage analysis, identifying available policyholder benefits, creating sub-claims when needed, investigating facts and potential recovery, reviewing damages and applicable law, evaluating financial loss, approving appropriate payments, and referring claims to other company units as necessary. The specialist also negotiates claim settlements, maintains and codes claim files, and completes closure activities in the claims management system. This is a hybrid arrangement, with time divided between the office and remote work. Office attendance may be weekly, monthly, or as needed depending on the role and leadership assessment; employees are generally expected to attend important departmental meetings or team-building events. The role may involve travel outside the assigned territory, including overnight stays, and the qualifications indicate flexibility to relocate or work evenings or weekends. The advertised annual salary is $70,000–$80,000, with the opportunity for an annual company bonus incentive. Benefits include health, dental, and vision coverage; life and disability insurance options; a 401(k) with company contributions; HSA and FSA options; PTO and paid holidays; paid leave programs; tuition assistance; professional certification reimbursement; career development opportunities; AAA membership; and adoption assistance.

Requirements

Florida State Adjuster License if required in the state for an adjuster's role.
A degree in Business Administration, Insurance, or a related field, or equivalent related work experience.
A valid driver's license if primary responsibilities involve conducting in-person inspections or frequent in-person meetings with members.
Three years of experience or equivalent training in negotiating claim settlements, securing and evaluating evidence, preparing manual and electronic estimates, subrogation claims, resolving coverage questions, taking statements, and establishing claim evaluation and resolution plans.
Advanced knowledge of the Fair Trade Practices Act as it relates to claims, subrogation procedures and processes, intercompany arbitration, and handling simple litigation.
Advanced knowledge of negligence law, no-fault law, medical terminology, and human anatomy.
Ability to handle claims according to Claim Handling Standards and apply ACG Claim policies, procedures, and guidelines.
Ability to work within assigned ACG Claim systems, including basic PC software.
Ability to perform basic claim file reviews and investigations.
Effective verbal and written communication skills.
Customer service skills, including building and maintaining relationships with insureds and claimants, understanding their problems, and responding to questions and concerns.
Problem-solving and sound decision-making skills.
Ability to prioritize claim-related functions and process time-sensitive information from multiple sources.
Time management, organization, and workload-planning skills.
Ability to research, analyze, and interpret subrogation laws in various states.
Ability to travel outside the assigned territory, which may involve overnight stays.
Flexibility to relocate or work evenings or weekends, as listed in the qualifications.

Nice To Haves

Associate degree in Business Administration, Insurance, or a related field, or equivalent related work experience.
Completion of the ACG Claim Representative Training Program or equivalent knowledge or experience.
Completion of the Insurance Institute of America's General Insurance Program, Associate in Claims, Associate in Management, or equivalent.
CPCU coursework or designation.

Responsibilities

Review assigned claims.
Contact the insured and other affected parties and set expectations for the remainder of the claim process.
Initiate and maintain documentation in the claim-handling system.
Complete complex coverage analysis and identify all possible policyholder benefits.
Create additional sub-claims when needed.
Investigate claim facts to determine whether a claim should be paid, applicable limits or exclusions, and potential recovery.
Review damages and determine the applicability of state law and other relevant factors.
Evaluate the financial value of the loss.
Approve payments for the appropriate parties.
Refer claims to other company units when necessary, such as Underwriting, Recovery Units, or the Claims Special Investigation Unit.
Document and/or code the claim file and complete claim closure and related activities in the claims management system.
Negotiate claim settlements.
Travel outside the assigned territory, potentially including overnight stays, as indicated in the qualifications.

Benefits

Medical plans with multiple coverage options, including HSA eligibility.
Prescription drug coverage.
Dental and vision benefits.
Employee Assistance Program.
Company-paid basic life insurance and optional supplemental life insurance and dependent coverage.
Short-term and long-term disability coverage.
Critical illness, accident, and pet insurance options.
401(k) plan with company contributions and immediate vesting of the match.
Health Savings Account and Flexible Spending Account options.
Accrual-based paid time off.
Company-paid holidays, a mental health day, floating holidays, and a volunteer day for eligible full-time employees.
Paid parental, bereavement, jury duty, and military leave.
Tuition assistance.
Professional certification support with reimbursement for eligible programs.
Career development and advancement opportunities.
Complimentary AAA membership with roadside assistance and travel discounts.
Adoption assistance.
Opportunity for an annual company bonus incentive.