AAA-The Auto Club Group · 4 hours ago
Senior Casualty Litigation Claim Specialist
Hybrid - FL
Full-time
Hybrid
Senior Level
$80K/yr - $95K/yr
5+ years expAAA The Auto Club Group is committed to driving careers forward and is seeking a Senior Casualty Litigation Claim Specialist. In this role, you will review and manage complex claims, conduct investigations, and ensure policyholder benefits are identified and processed accordingly.
Insurance
Responsibilities
Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system
Complete coverage analysis on the most complex claims
Handle large loss injury claims
Ensure all possible policyholder benefits are identified
Create additional sub-claims if needed
Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential
Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim
Evaluate the financial value of the loss
Approve payments for the appropriate parties accordingly
Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit)
Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system
Utilize strong negotiating skills
Senior Claim Specialists are assigned Liability/BI/MedPay/Non-MI PIP/HO Liability/UM/UIM claims involving litigation/arbitration. The Senior Claim Specialists handle the most complex claims involving liability disputes, bodily injuries, and coverage questions
Qualification
Required
Associate degree in Business Administration, Insurance, or a related field, or the equivalent in related work experience
Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management, or equivalent
CPCU coursework or designation
Complete the ACG Training Program or demonstrate equivalent knowledge or experience
In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain it as specified for the appropriate states
Must have a valid State Driver's License
Five years of experience in the following: 1st and 3rd party auto injury, homeowner liability, personal injury, and umbrella policies
Managing and handling claims where litigation or arbitration has been filed
Working with defense counsel
Multi-state claim/venue knowledge
Resolving complex coverage questions
Large loss claims
Negotiation of complex claim settlements
Securing and evaluating evidence and claims supports
Comfort with multi-system and software program usage
Subrogation claims and investigation
Taking statements
Establishing clear evaluation and resolution plans for claims
Advanced technical knowledge of Essential Insurance Act (Michigan)
Advanced technical knowledge of Fair Trade Practices Act as it relates to claims
Advanced technical knowledge of Subrogation procedures and processes
Advanced technical knowledge of Microsoft products
Advanced technical knowledge of Intercompany arbitration
Advanced technical knowledge of Litigation
Advanced technical knowledge of Large Loss
Advanced technical knowledge of Coverage
Advanced technical knowledge of Medical terminology
Advanced technical knowledge of Negligence Law
Advanced technical knowledge of No-Fault Law
Advanced technical knowledge of medical terminology and human anatomy
Advanced technical knowledge of Insurance Policy Review and Understanding
Advanced technical knowledge of Coverage Review and letter writing
Ability to handle claims according to the established Claim Handling Standards
Ability to follow and apply ACG Claim policies, procedures, and guidelines
Ability to work within the assigned ACG Claim systems, including basic PC software
Ability to perform claim file review and investigations
Ability to demonstrate effective communication skills (verbal and written)
Ability to demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
Ability to analyze and solve problems while demonstrating sound decision-making skills
Ability to prioritize claim-related functions
Ability to process time-sensitive data and information from multiple sources
Ability to manage time, organize, and plan workload and responsibilities
Ability to safely operate a motor vehicle in order to attend meetings off-site
Ability to travel outside of the assigned territory, which may involve overnight stay
Ability to relocate, work evenings or weekends
Preferred
Associate degree in Business Administration, Insurance, or a related field or the equivalent in related work experience
Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management, or equivalent
CPCU coursework or designation
Benefits
401k Match
Medical
Dental
Vision
PTO
Paid Holidays
Tuition Reimbursement
Company
AAA-The Auto Club Group
AAA - The Auto Club Group (ACG) is the second largest AAA club in North America, serving more than 13+ million members across 14 U.S.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Joseph Richardson Jr
President and CEO
Peggy Gartin, CFA
SVP | Chief Investment Officer
Company data provided by crunchbase