Remote Medical Claims Processor Jobs in Lancaster, CA

Claims Field Senior Property Adjuster

Job Summary

This position handles moderate to complex claims matters involving homeowner property insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include investigation, damages evaluation, negotiation strategies, and claims resolution of moderate to complex claims. The position employs discretion and independent judgment to ensure compliance with state and federal law and established company Best Practices.
Job Duties

• Identify and obtain statements from insureds, vendors and witnesses. Conduct phone and/or field investigations to determine coverage and damages and differentiate between allegations and facts in each loss.

• Communicate and interact with a variety of individuals. Explain benefits, coverages, and claims process either verbally or in writing in compliance with regulatory and statutory requirements. Recognize and appropriately address moderate complexity coverage issues.

• Evaluate and determine claim values upon receipt and assessment of property damage data.

• Negotiate within settlement authority with insureds to resolve first claims.

• Update database production reports, and document and update claim files via company systems, i.e. CACS, HUON, HOC, GUIDEWIRE, etc.

• Control expenses for areas of responsibility.

• Verify and interpret / resolve coverage by gathering necessary information to ensure policy applicability. Objectively discern and address issues that may be questioned in audit. Coordinate with internal and external departments as required.

• May attend and participate in legal proceedings.

• Respond quickly and effectively to customer needs and problems.

Qualifications

• Bachelors Equivalent combination of education and experience

• 4-6 years Prior claims handling experience. Required

• 4-6 years Property claims administration experience. Preferred

• 1-3 years Experience in the construction industry. Preferred

• Working knowledge of claims administration best practices and procedures.

• Moderate knowledge of insurance, fault assessment, negligence and subrogation principles required.

• Comprehensive understanding of vehicle and building repair procedures and third-party liability issues.

• Working knowledge of Microsoft Office suite, general computer software and claims software.

• Moderate leadership skills necessary.

• Advanced organization and planning recognition skills required.

• Advanced oral and written communication skills required.

• Advanced interpersonal skills required.

• Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required

• An insurance/claims adjuster license may be required for claims administration in specific states.

Travel Requirements

• Claims field duties may involve company car usage and local travel to inspect accident scenes or first-party homeowner losses.

The starting pay range for this position is:

$80,100.00 - $107,000.00

Additionally, for full time positions, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance.

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Remarkable benefits:
Health coverage for medical, dental, vision

401(K) saving plans with company match AND Pension

Tuition assistance

Floating holidays and PTO for community volunteer programs

Paid parental leave

Wellness programs

Employee discounts (membership, insurance,

travel, entertainment, services and more!)

Auto Club Enterprises is the largest club within the national AAA federation. We have nearly 17,000 employees in 24 states helping more than 18 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity - we win. All of Us! With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

"Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value."

AAA is an Equal Opportunity Employer

Our organization participates in E-Verify

The Automobile Club of Southern California will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), the Unincorporated Los Angeles County (ULAC) regulation, and the California Fair Chance Act (CFCA).