Claims Senior MedPay Adjuster

AAA•Lincoln, RI

10d

About The Position

The Claims Senior MedPay Adjuster handles moderate- to high-complexity auto claims involving material damage, property, and/or liability lines of insurance written by the Interinsurance Exchange. The role evaluates coverage and liability, investigates claims, and negotiates settlements while complying with regulatory and statutory requirements and established company, technical, and customer service practices. The adjuster uses discretion and independent judgment to resolve claim exposures within their authority and respond to customer needs.

Requirements

Bachelor’s degree or equivalent combination of education and experience.
7–9 years of property, auto, casualty, or relevant claims administration experience required.
Comprehensive knowledge of claims administration best practices and procedures.
Comprehensive knowledge of building and vehicle repair procedures and third-party liability issues.
Extensive knowledge of insurance, fault assessment, negligence, and subrogation principles.
Advanced knowledge of Microsoft Office, general computer software, and claims software.
Advanced organization and planning skills.
Advanced oral and written communication skills.
Advanced interpersonal skills.
Advanced leadership skills among peers.
Valid driver’s license, acceptable Department of Motor Vehicles record, and minimum liability insurance as issued by the state.
An insurance or claims adjuster license may be required for claims administration in specific states.

Nice To Haves

7–9 years of prior claims handling experience.

Responsibilities

Communicate with insureds, claimants, and other individuals, explaining benefits, coverage, fault, and the claims process verbally or in writing.
Recognize and address coverage issues, gathering information to verify policy applicability and resolve coverage questions.
Conduct phone investigations to determine liability and damages.
Identify and obtain statements from insureds, claimants, and witnesses.
Evaluate claim values based on property, bodily injury, and liability information.
Negotiate within settlement authority with insureds and claimants to resolve first- and third-party claims.
Update production reports and document and update claim files using company systems, including CACS, HUON, HOC, and Guidewire.
Control expenses within areas of responsibility.
Coordinate with internal and external departments as needed.
Independently resolve claim exposures within the assigned level of authority.
Respond promptly to customer needs and problems.
Attend and participate in legal proceedings as needed.
Travel occasionally to off-site business meetings or conferences.

Benefits

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