Casualty Claim Specialist - Florida

AAA-The Auto Club Group

1d•Hybrid

About The Position

The Auto Club Group is seeking prospective Casualty Claim Specialist who can work under less supervision with a high-level of authority to handle highly complex technical issues and the most complex claims. This position offers the opportunity to lead to a rewarding career at a growing organization. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.

Requirements

In states where an Adjuster’s license is required, the candidate must have a Florida State Adjuster License
Degree in Business Administration, Insurance or a related field or the equivalent in related work experience
Must have a valid State Driver's License
Three years of experience or equivalent training in Negotiation of claim settlements
Three years of experience or equivalent training in Evaluation of injury claims
Three years of experience or equivalent training in Securing and evaluating evidence
Three years of experience or equivalent training in Subrogation claims
Three years of experience or equivalent training in Coverage analysis and resolution of coverage questions
Three years of experience or equivalent training in Taking statements
Three years of experience or equivalent training in Establishing clear evaluation and resolution plans for claims
Knowledge of Fair Trade Practices Act as it relates to claims
Knowledge of Subrogation including intercompany arbitration
Knowledge of Litigation as it relates to claims
Knowledge of Negligence Law
Knowledge of No-Fault Law
Knowledge of Medical terminology and human anatomy
Ability to handle claims to ACG Claim Handling Standards including following and applying ACG Claim policies, procedures, and guidelines
Ability to work within assigned ACG Claim systems including basic PC software
Ability to perform claim file review and investigations
Ability to demonstrate effective communication skills (verbal and written)
Ability to demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
Ability to analyze and solve problems while demonstrating sound decision making skills
Ability to prioritize claim related functions
Ability to process time sensitive data and information from multiple sources
Ability to manage time, organize, and plan workload and responsibilities

Nice To Haves

Degree in Business Administration, Insurance or a related field or the equivalent in related work experience
Completion of the Insurance Institute of America's: General Insurance Program
Completion of the Insurance Institute of America's: Associate in Claims
Completion of the Insurance Institute of America's: Associate in Management or equivalent CPCU coursework or designation

Responsibilities

Reviewing assigned claims
Contacting the insured and other affected parties
Setting expectations for the remainder of the claim process, and thoroughly documenting activities in the claim file
Complete complex coverage analysis
Ensure all possible policyholder benefits are identified
Complete an investigation of the facts regarding the claim
Determine if the claim should be paid and confirm recovery potential
Conducting thorough reviews of damages and determining the applicability of state law and other factors related to the claim
Identify when to refer claims to other company units (e.g., Underwriting, Subrogation or Special Investigation Unit)
Possess strong critical thinking and negotiating skills
Handle both attorney represented and unrepresented claimants with injury claims that may involve coverage investigation, liability disputes, bodily injuries, and litigation
Assist Claim Manager with file reviews and training