Claims Senior Medpay Adjuster

AAA • Coppell, TX

11d

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 requires compliance with regulatory and statutory requirements, state and federal law, and company, technical, and customer-service best practices. The adjuster uses discretion and independent judgment to investigate liability, evaluate coverage, and negotiate claims. The position may involve attending legal proceedings and occasional travel to off-site business meetings or conferences.

Requirements

• Bachelor’s degree or an equivalent combination of education and experience.
• 7–9 years of prior claims-handling experience (preferred).
• 7–9 years of property, auto, casualty, or relevant claims-administration experience (preferred).
• 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 issued by the state.
• An insurance or claims adjuster license may be required for claims administration in specific states.

Responsibilities

• Communicate with insureds, claimants, and other individuals; explain benefits, coverage, fault, and the claims process verbally or in writing in compliance with applicable requirements.
• Recognize and appropriately address coverage issues.
• Conduct phone investigations to determine liability and damages.
• Identify and obtain statements from insureds, claimants, and witnesses.
• Gather information to verify, interpret, and resolve coverage and determine policy applicability.
• 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 database production reports and document and update claim files using company systems.
• Control expenses within areas of responsibility.
• Coordinate with internal and external departments as required.
• Independently resolve claim exposures within assigned authority.
• Respond promptly to customer needs and problems.
• May attend and participate in legal proceedings.
• Travel occasionally to off-site business meetings or conferences.

Benefits

• Health coverage for medical, dental, and vision
• 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

What This Job Offers

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