Casualty Claim Specialist - Florida

AAA-The Auto Club Group

1d•Hybrid

About The Position

This is a hybrid work arrangement (time spent in office and remote). This candidate must reside within the state of Florida, preferably near Tampa. Depending on the employee's role and leadership's assessment, some employees will come into an ACG facility on a weekly basis, a monthly basis, or on an "as needed" basis for key meetings and collaborative activities. Most employees will be required to come into the office, at a minimum, for important departmental meetings or teambuilding events. 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. In this position, you will have the opportunity to review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and thoroughly document activities in the claim file. You will also complete complex coverage analysis, ensure all possible policyholder benefits are identified, investigate the facts regarding the claim, and determine if the claim should be paid and confirm recovery potential. This role involves conducting thorough reviews of damages and determining the applicability of state law and other factors related to the claim. You will identify when to refer claims to other company units (e.g., Underwriting, Subrogation or Special Investigation Unit). The position requires strong critical thinking and negotiating skills. You will handle both attorney represented and unrepresented claimants with injury claims that may involve coverage investigation, liability disputes, bodily injuries, and litigation. Additionally, you will assist the Claim Manager with file reviews and training. With our powerful brand and the mentoring we offer, you will find your position as a Claim Specialist can lead to a rewarding career at our growing organization.

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 the following: Negotiation of claim settlements, Evaluation of injury claims, Securing and evaluating evidence, Subrogation claims, Coverage analysis and resolution of coverage questions, Taking statements, Establishing clear evaluation and resolution plans for claims
Knowledge of: Fair Trade Practices Act as it relates to claims, Subrogation including intercompany arbitration, Litigation as it relates to claims, Negligence Law, No-Fault Law, Medical terminology and human anatomy
Ability to: Handle claims to ACG Claim Handling Standards including following and applying ACG Claim policies, procedures, and guidelines, Work within assigned ACG Claim systems including basic PC software, Perform claim file review and investigations, Demonstrate effective communication skills (verbal and written), Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns, Analyze and solve problems while demonstrating sound decision making skills, Prioritize claim related functions, Process time sensitive data and information from multiple sources, 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, Associate in Claims, 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
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)
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