Claims Complex Property Adjuster

AAA • Costa Mesa, CA

4d • $39 - $51

About The Position

Claims Complex Property Adjuster Job Summary This position supports the Property Claims operation by handling claims reported on Homeowner policies written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The position handles claims of high complexity. The primary functions include interpreting information from First Notice of Loss reports, loss investigation, coverage and damages evaluation, negotiation strategies and claims resolution. Employs discretion and independent judgment to ensure compliance with state and federal laws. Applies technical and customer service best practices in accordance with company guidelines. Job Duties Identify and obtain statements from insureds, claimants and witnesses. Conduct phone investigations to determine coverage and damages and differentiate between allegations and facts in each loss. Determine policy obligations by assessing the liability and damage components of the loss. Responsible for maintaining proper activities and service levels. Communicate and interact with a variety of individuals, including members, insureds, claimants, and vendors, as well as coordinating with internal and external departments. Explain policy coverages, benefits, and claims process verbally and/or in writing in compliance with regulatory and statutory requirements. Recognize and appropriately address complex coverage and subrogation issues. Evaluate, assess, and negotiate within settlement authority with insureds to resolve first-party claims in multiple markets. Demonstrate proficiency with assessment of personal property, property damage, coverage, loss of use, arbitration responses, damage evaluations, and claims technology and tool usage. Objectively discern and address issues that may be questioned in an audit. Mentor and assist with the training of less experienced personnel within the Claims promotional/development guidelines and provide coaching in files. May attend and participate in legal proceedings. Direct and interact with in-house and outside counsel on litigated files. Provide sworn expert testimony in Courtroom or Deposition settings. Prepare comprehensive formal reporting on high-profile claims to senior management. Respond quickly to customer needs and problems.

Requirements

• Bachelors Equivalent combination of education and experience
• 7-9 years Prior claims handling experience.
• 7-9 years Property claims administration experience.
• Working knowledge of claims administration best practices and procedures.
• Advanced knowledge of insurance, coverage investigation, scope and damage assessment, negligence and subrogation principles required.
• Advanced knowledge of Microsoft Office suite, general computer software and claims software.
• Comprehensive understanding of building and vehicle repair procedures and third-party liability issues.
• Advanced leadership skills among peers required.
• Advanced organization and planning recognition skills required
• Advanced oral and written communication skills required.
• Advanced interpersonal skills required.
• Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required
• An insurance/claims adjuster license may be required for claims administration in specific states.

Nice To Haves

• Chartered Property Casualty Underwriter - Insurance Institute of America Preferred
• Associate in Claims - Insurance Institute of America Preferred

Responsibilities

• Identify and obtain statements from insureds, claimants and witnesses.
• Conduct phone investigations to determine coverage and damages and differentiate between allegations and facts in each loss.
• Determine policy obligations by assessing the liability and damage components of the loss.
• Responsible for maintaining proper activities and service levels.
• Communicate and interact with a variety of individuals, including members, insureds, claimants, and vendors, as well as coordinating with internal and external departments.
• Explain policy coverages, benefits, and claims process verbally and/or in writing in compliance with regulatory and statutory requirements.
• Recognize and appropriately address complex coverage and subrogation issues.
• Evaluate, assess, and negotiate within settlement authority with insureds to resolve first-party claims in multiple markets.
• Demonstrate proficiency with assessment of personal property, property damage, coverage, loss of use, arbitration responses, damage evaluations, and claims technology and tool usage.
• Objectively discern and address issues that may be questioned in an audit.
• Mentor and assist with the training of less experienced personnel within the Claims promotional/development guidelines and provide coaching in files.
• May attend and participate in legal proceedings.
• Direct and interact with in-house and outside counsel on litigated files.
• Provide sworn expert testimony in Courtroom or Deposition settings.
• Prepare comprehensive formal reporting on high-profile claims to senior management.
• Respond quickly to customer needs and problems.

Benefits

• Health coverage for medical, dental, vision
• 401(K) saving plans with company match AND Pension
• Tuition assistance
• Floating holidays and PTO for community volunteer programs
• Paid parental leave
• Wellness programs
• Employee discounts (membership, insurance, travel, entertainment, services and more!)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 101-250 employees