Claims Service Representative 3 - Quality Assurance

This position is for Property department and is intended for a candidate with hands-on experience in both field and desk property claim handling who is interested in transitioning into a Quality Assurance role.

This position Audits moderate to high complexity claims matters involving property lines of insurance written by the Interinsurance Exchange. The primary function is to independently Audit property claim files across all ACE markets, with a primary focus on file handling, regulatory compliance, and loss payment accuracy. Employs discretion and independent judgment to ensure compliance with state and federal law, and with established company, technical, and customer service best practices.

• Conduct audits of property files to identify trends, patterns, or anomalies in the claims handling process

• Communicate and interact with a variety of individuals including insureds and claimants. Explain benefits, coverages, fault and claims process either verbally or in writing in compliance with regulatory and statutory requirements.

• Evaluate and determine claim values upon receipt and assessment of property, bodily injury and liability data.

• Produce clear, concise audit write-ups that summarize findings and actionable recommendations for claim handling.

• Control expenses for areas of responsibility.

• Verify and interpret / resolve coverage by gathering necessary information to ensure policy applicability. Coordinate with internal and external departments as required.

• The position requires a higher degree of discretion and independent judgment in analysis and problem solving to effectively manage losses. Determine policy obligations by assessing the liability and damage components of the loss. Investigate and differentiate between allegations and facts in each loss. Respond quickly and effectively to customer needs and problems.

• Recognize and appropriately address complex coverage issues.

• Recognize and appropriately address complex subrogation issues.

Qualifications

• Bachelor’s or equivalent combination of education and experience.

• 7-9 years of claims handling experience.

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

• Moderate computer and line of business technical software skills required.

• Moderate knowledge of fault assessment and subrogation principles required.

• Moderate leadership competencies are 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 is required.

The starting pay range for this position is $72,700 to $96,800, annually. Additionally, you will be eligible to participate in our incentive program based upon the achievement of organization, team, and personal performance.

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!)

"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

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