Claims Senior MedPay Adjuster
AAA • Lincoln, RI13d • $36 - $48
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Claims Senior MedPay Adjuster
AAA•Lincoln, RI
•$36 - $48
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 ensures compliance with regulatory and statutory requirements and established company, technical, and customer-service best practices. It exercises discretion and independent judgment in liability investigation, coverage evaluation, and negotiation of claims. The adjuster communicates with insureds, claimants, and others; explains benefits, coverage, fault, and the claims process; investigates liability and damages; assesses claim values; negotiates settlements within assigned authority; and resolves claim exposures independently within that authority. The position also maintains claim files and production reports in company systems, controls expenses, coordinates with internal and external departments, responds to customer needs, and may participate in legal proceedings. The position requires occasional travel to off-site business meetings or conferences (approximately 5%). The starting pay range is $35.94–$47.87 per hour, with eligibility for an incentive program based on organizational, team, and personal performance. Auto Club Enterprises is part of the national AAA federation and has nearly 17,000 employees in 24 states, serving more than 18 million members.
Requirements
- Required: 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; state-issued.
- 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, explaining benefits, coverages, fault, and the claims process verbally or in writing in compliance with regulatory and statutory requirements.
- Recognize and address coverage issues appropriately.
- Conduct phone investigations to determine liability and damages; identify and obtain statements from insureds, claimants, and witnesses.
- Gather necessary information to verify and resolve coverage and ensure policy applicability.
- Evaluate and determine claim values after assessing property, bodily injury, and liability data.
- Negotiate with insureds and claimants within settlement authority to resolve first- and third-party claims.
- Update production reports and document and maintain claim files using company systems, including CACS, HUON, HOC, and GUIDEWIRE.
- Control expenses for 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.
Benefits
- Health coverage for medical, dental, and vision
- 401(k) savings plan with company match
- Pension
- Tuition assistance
- Floating holidays
- PTO for community volunteer programs
- Paid parental leave
- Wellness programs
- Employee discounts on membership, insurance, travel, entertainment, services, and more
- Incentive program based on organizational, team, and personal performance
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
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