Claims Senior Medpay Adjuster

AAA • Coppell, TX

12d

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 performs liability investigations, evaluates coverage, and negotiates claims while complying with regulatory and statutory requirements. It requires discretion and independent judgment to ensure compliance with state and federal law and company, technical, and customer-service best practices.

The adjuster communicates with insureds, claimants, witnesses, and other parties; explains benefits, coverage, fault, and the claims process; investigates liability and damages; evaluates claim values; and negotiates settlements within authorized limits. The role also documents and updates claim files and production reports in company systems, controls expenses, coordinates with internal and external departments, independently resolves claim exposures within authority, responds to customer needs, and may participate in legal proceedings. Occasional travel to off-site business meetings or conferences is required.

Requirements

• 7–9 years of prior claims handling experience.
• 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.

Nice To Haves

• Bachelor's degree or equivalent combination of education and experience preferred.
• 7–9 years of property, auto, casualty, or relevant claims administration experience preferred.

Responsibilities

• Communicate with insureds, claimants, and other individuals, and explain benefits, coverage, fault, and the claims process verbally or in writing in compliance with regulatory and statutory 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 necessary information to verify, interpret, and resolve coverage and ensure policy applicability.
• Evaluate and determine claim values based on property, bodily injury, and liability information.
• Negotiate with insureds and claimants within settlement authority to resolve first- and third-party claims.
• Update database production reports and document and update claim files using company systems.
• Control expenses for areas of responsibility.
• Coordinate with internal and external departments as required.
• Independently resolve claim exposures within the assigned level of authority.
• Respond quickly 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 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed