Casualty Claim Specialist - Florida

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

6d•$70,000 - $80,000•Hybrid

About The Position

As a Pre-Litigation Bodily Injury Adjuster, you will be at the forefront of resolving complex injury claims and delivering meaningful outcomes for customers during some of life's most challenging moments. In this highly impactful role, you will investigate, evaluate, negotiate, and resolve bodily injury claims before litigation, leveraging your expertise. This position offers an exciting opportunity to make informed decisions, manage a dynamic caseload, and play a key role in achieving exceptional claim results through proactive engagement and strategic claim handling.

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
A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.
Three years of experience or equivalent training in negotiation of claim settlements
securing and evaluating evidence
preparing manual and electronic estimates
subrogation claims
resolving coverage questions
taking statements
establishing clear evaluation and resolution plans for claims
Advance knowledge of Fair Trade Practices Act as it relates to claims
Advance knowledge of Subrogation procedures and processes
Advance knowledge of Intercompany arbitration
Advance knowledge of Handling simple litigation
Advance knowledge of Negligence Law
Advance knowledge of No-Fault Law
Advance knowledge of medical terminology and human anatomy
handle claims to the line Claim Handling Standards
follow and apply ACG Claim policies, procedures and guidelines
work within assigned ACG Claim systems including basic PC software
perform basic claim file review and investigations
demonstrate effective communication skills (verbal and written)
demonstrate customer service skills by building and maintaining relationships with insured/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
research analyze and interpret subrogation laws in various states
travel outside of assigned territory which may involve overnight stay
relocate, work evenings or weekends

Nice To Haves

Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
Complete ACG Claim Representative Training Program or demonstrate 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

Reviewing assigned claims
Contacting the insured and other affected parties
Setting expectations for the remainder of the claim process
Initiating documentation in the claim handling system
Complete complex coverage analysis
Ensure all possible policyholder benefits are identified
Create additional sub-claims if needed
Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential
Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim.
Evaluate the financial value of the loss.
Approve payments for the appropriate parties accordingly.
Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit).
Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system.
Utilize strong negotiating skills.

Benefits

PTO, paid sick leave
Medical plans with multiple coverage options, including HSA eligibility.
Prescription drug coverage.
Dental and vision benefits.
Employee Assistance Program (confidential support services).
Company-paid basic life insurance.
Optional supplemental life insurance and dependent coverage.
Short-term and long-term disability coverage.
Critical illness, accident, and pet insurance options.
401(k) plan
Health Savings Account (HSA) and Flexible Spending Accounts (FSA) options.
Paid Time Off (PTO)
Paid holidays
mental health day
floating holidays
volunteer day
Paid leave programs, including parental, bereavement, jury duty, and military leave.
Tuition assistance (up to $5,250 annually; 80% covered by ACG).
Professional certification support with 100% reimbursement for eligible programs.
Opportunities for career development and advancement.
Complimentary AAA membership with roadside assistance and travel discounts.
Adoption assistance program.