Injury Examiner

USAA•San Antonio, TX

4d•Hybrid

About The Position

As a dedicated Injury Examiner, you will be responsible for adjusting complex auto and homeowner bodily injury claims, UM/UIM, and small business claims. This includes confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. You will be responsible for delivering a concierge level of best-in-class member service through setting appropriate expectations, proactive communications, advice, and empathy. This hybrid role requires an individual to be in the office 3 days per week. This position can be based in one of the following locations: Tampa, FL, San Antonio, TX, Phoenix, AZ, Colorado Springs, CO, or Chesapeake, VA. Relocation assistance is not available for this position.

Requirements

High School Diploma or General Equivalency Diploma.
4 years auto claims and injury adjusting experience.
Advanced knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of claims as well as application of case law and state laws and regulations.
Advanced negotiation, investigation, communication, and conflict resolution skills.
Demonstrated strong time-management and decision-making skills.
Proven investigatory, prioritizing, multi-tasking, and problem-solving skills.
Advanced knowledge of human anatomy and medical terminology associated with bodily injury claims.
Ability to exercise sound financial judgment and discretion in handling insurance claims.
Advanced knowledge of coverage evaluation, loss assessment, and loss reserving.
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.

Nice To Haves

2 or more years of high-value catastrophic injury experience (e.g. traumatic brain injury, disfigurement, fatality) to include UM/UIM coverage
College Degree (Bachelor’s or higher)
Insurance Designation
US military experience through military service or a military spouse/domestic partner [optional]

Responsibilities

Adjusts complex auto bodily injury claims with significant injuries (e.g. traumatic brain injury, disfigurement, fatality) and UM/UIM, and small business claims, as well as some auto physical damage associated with those claims.
Identifies, confirms, and makes coverage decisions on complex claims.
Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes.
Prioritizes and manages assigned claims workload to keep members and other involved parties informed and provides timely claims status updates.
Collaborates and supports team members to resolve issues and identifies appropriate matters for escalation.
Partners and/or directs vendors and internal business partners to facilitate timely claims resolution.
Serves as a resource for team members on complex claims.
Delivers a best-in-class member service experience by setting appropriate expectations and providing proactive communication.
Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.