Claims Complex Property Adjuster CA

AAA • Costa Mesa, CA

1d

About The Position

This position supports the Property Claims operation by handling high-complexity claims reported on Homeowner policies written by the Interinsurance Exchange. The adjuster investigates losses, determines coverage and damages, develops negotiation strategies, and resolves claims in compliance with regulatory and statutory requirements. The role requires discretion and independent judgment, while applying technical and customer-service best practices in accordance with company guidelines.

The position also supports the development of less experienced claims personnel through mentoring, training, and file coaching. It may involve legal proceedings, coordination with in-house and outside counsel on litigated files, sworn expert testimony, and comprehensive reporting on high-profile claims to senior management. Occasional travel to off-site business meetings or conferences is required.

Requirements

• Bachelor’s degree or equivalent combination of education and experience.
• 7–9 years of 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.
• Advanced knowledge of Microsoft Office, general computer software, and claims software.
• Comprehensive understanding of building and vehicle repair procedures and third-party liability issues.
• Advanced leadership skills among peers.
• Advanced organization, planning, and recognition skills.
• Advanced oral and written communication skills.
• Advanced interpersonal skills.
• Valid driver’s license, acceptable Department of Motor Vehicles record, and minimum liability insurance.

Nice To Haves

• 7–9 years of prior claims handling experience.
• Chartered Property Casualty Underwriter designation from the Insurance Institute of America.
• Associate in Claims designation from the Insurance Institute of America.
• An insurance or claims adjuster license may be required for claims administration in specific states.

Responsibilities

• Identify and obtain statements from insureds, claimants, and witnesses.
• Conduct phone investigations to determine coverage and damages and distinguish allegations from facts.
• Determine policy obligations by assessing liability and damage components of losses.
• Maintain appropriate claim activities and service levels.
• Communicate with members, insureds, claimants, vendors, and internal and external departments.
• Explain policy coverages, benefits, and the claims process verbally or in writing in compliance with regulatory and statutory requirements.
• Recognize and address complex coverage and subrogation issues.
• Evaluate, assess, and negotiate first-party claims within settlement authority across multiple markets.
• Assess personal property, property damage, coverage, loss of use, arbitration responses, and damage evaluations, and use claims technology and tools.
• Identify and address issues that may be questioned in an audit.
• Mentor and assist in training less experienced personnel and provide coaching on files.
• Attend and participate in legal proceedings as needed.
• Direct and interact with in-house and outside counsel on litigated files.
• Provide sworn expert testimony in courtroom or deposition settings.
• Prepare comprehensive formal reports on high-profile claims for senior management.
• Respond promptly to customer needs and problems.
• Travel occasionally to off-site business meetings or conferences.

Benefits

• Medical, dental, and vision coverage.
• 401(k) savings plan with company match and pension.
• Tuition assistance.
• Floating holidays and paid time off for community volunteer programs.
• Paid parental leave.
• Wellness programs.
• Employee discounts on membership, insurance, travel, entertainment, services, and more.
• Incentive program eligibility for full-time positions, based on organization, team, and personal performance.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior