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USAA · 1 month ago

Injury Examiner

Tampa Crosstown

Full-time

Hybrid

Mid Level

$85K/yr - $163K/yr

4+ years exp

USAA is committed to empowering its members to achieve financial security through exceptional service and products. As an Injury Examiner, you will adjust complex bodily injury claims and provide best-in-class member service while ensuring compliance with state laws and regulations.

BankingFinancial ServicesInsuranceVenture Capital

No H1B

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

Qualification

Auto claims adjustingInvestigation skillsState lawsNegotiation skillsMedical terminologyTime managementConflict resolutionProblem-solving skillsMulti-taskingFinancial judgmentLoss assessmentInsurance adjuster licenseCommunication skills

Required

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