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AAA-The Auto Club Group · 1 day ago

Casualty Claim Specialist - Florida

Tampa, FL

Full-time

Hybrid

Mid Level

$68K/yr - $78K/yr

3+ years exp

AAA The Auto Club Group is a leading provider of membership, travel, insurance, and financial services. They are seeking a Casualty Claim Specialist to handle complex claims, conduct thorough reviews, and ensure all policyholder benefits are identified while working under minimal supervision.

Responsibilities

Reviewing assigned claims

Contacting the insured and other affected parties

Setting expectations for the remainder of the claim process, and thoroughly documenting activities in the claim file

Complete complex coverage analysis

Ensure all possible policyholder benefits are identified

Complete an investigation of the facts regarding the claim

Determine if the claim should be paid and confirm recovery potential

Conducting thorough reviews of damages and determining the applicability of state law and other factors related to the claim

Identify when to refer claims to other company units (e.g., Underwriting, Subrogation or Special Investigation Unit)

Possess strong critical thinking and negotiating skills

Handle both attorney represented and unrepresented claimants with injury claims that may involve coverage investigation, liability disputes, bodily injuries, and litigation

Assist Claim Manager with file reviews and training

Qualification

Florida State Adjuster LicenseNegotiation of claim settlementsCoverage analysisEvaluation of injury claimsSubrogation claimsMedical terminologyCustomer service skillsEffective communicationProblem-solving skillsTime management

Required

In states where an Adjuster's license is required, the candidate must have a Florida State Adjuster License

Degree in Business Administration, Insurance or a related field or the equivalent in related work experience

Must have a valid State Driver's License

Three years of experience or equivalent training in the following: Negotiation of claim settlements, Evaluation of injury claims, Securing and evaluating evidence, Subrogation claims, Coverage analysis and resolution of coverage questions, Taking statements, Establishing clear evaluation and resolution plans for claims

Knowledge of: Fair Trade Practices Act as it relates to claims, Subrogation including intercompany arbitration, Litigation as it relates to claims, Negligence Law, No-Fault Law, Medical terminology and human anatomy

Ability to: Handle claims to ACG Claim Handling Standards including following and applying ACG Claim policies, procedures, and guidelines, Work within assigned ACG Claim systems including basic PC software, Perform claim file review and investigations, Demonstrate effective communication skills (verbal and written), Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns, Analyze and solve problems while demonstrating sound decision making skills, Prioritize claim related functions, Process time sensitive data and information from multiple sources, Manage time, organize, and plan workload and responsibilities

Must Reside within 50 miles from Tampa, Florida