Claims Service Representative 1 - SIU

AAA - Automobile Club of Southern California; Escondido (CA); Remote; USD 60,000 - 85,000; Full time

Job summary

AAA - Automobile Club of Southern California is seeking a Claims Service Representative 1 for a Field/Work from Home opportunity. In this role, you will manage moderate to higher complexity claims, engaging in investigation, negotiation, and ensuring compliance with relevant laws and company standards. Candidates must possess a four-year degree and 5-15 years of relevant experience, with strong communication and analytical skills. You will also enjoy remarkable benefits including health coverage, a retirement plan, and employee discounts.

Benefits

Health coverage for medical, dental, vision

401(K) saving plan with company match

Pension plan

Tuition assistance

PTO for community volunteer programs

Wellness program

Employee discounts

Qualifications

• 5-15 years of claims servicing experience required.
• Litigation, investigation, or SIU experience required.
• Valid driver's license with acceptable record.

Responsibilities

• Handle moderate to higher complexity claims matters.
• Conduct investigations to determine liability and damages.
• Evaluate and determine claim values based on data assessment.

Skills

Strategic thinking

Critical thinking

Communication

Interpersonal skills

Education

Four-year college degree

Industry designations (preferred)

Tools

Guidewire

Job description

This position is a primarily a Field/Work from Home opportunity.

Candidates must live in the Southern California area.

In this position you will handle moderate to higher complexity claims matters involving material damage, property and/or liability/casualty/injury lines of insurance in compliance with all regulatory and statutory requirements. The primary functions include investigation, evaluation, and negotiation of moderate to higher complexity claims. Employs discretion and independent judgment to ensure compliance with state and federal law, and with established company, technical, and customer service best practices.

Conduct phone and/or field investigations to determine liability and damages.

May attend and participate in legal proceedings.

Identify and obtain statements from insureds, claimants, and witnesses.

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.

Update database production reports, and document and update claim files via company systems, i.e. Guidewire, etc.

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.

Employs discretion and independent judgment to ensure compliance with state and federal law, and with established company, technical, and customer service best practices.

Qualifications:

Four-year college degree or equivalent combination of education and experience required.

Evidence of continuing education (i.e. industry designations) preferred.

Ability to service claims of low, moderate, and higher complexity as normally acquired through 5-15 years’ experience.

Litigation, investigation or SIU experience required.

Strong strategic/critical thinking ability required.

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.

Advanced organization and planning recognition skills required.

Advanced oral and written communication skills and interpersonal skills required.

Valid driver's license with a level of financial responsibility required by the club and an acceptable motor vehicle record required for field positions.

Remarkable benefits:
• Health coverage for medical, dental, vision
• 401(K) saving plan with company match AND Pension
• Tuition assistance
• PTO for community volunteer programs
• Wellness program
• Employee discounts (membership, insurance, travel, entertainment, services and more!)

Auto Club Enterprises is the largest federation of AAA clubs in the nation. We have 14,000 employees in 21 states helping 17 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 1902, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

Claims Service Representative 1 - SIU

• This position is a primarily a Field/Work from Home opportunity.

• Candidates must live in the Southern California area.

In this position you will handle moderate to higher complexity claims matters involving material damage, property and/or liability/casualty/injury lines of insurance in compliance with all regulatory and statutory requirements. The primary functions include investigation, evaluation, and negotiation of moderate to higher complexity claims. Employs discretion and independent judgment to ensure compliance with state and federal law, and with established company, technical, and customer service best practices.

• Conduct phone and/or field investigations to determine liability and damages.

• May attend and participate in legal proceedings.

• Identify and obtain statements from insureds, claimants, and witnesses.

• 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.

• Update database production reports, and document and update claim files via company systems, i.e. Guidewire, etc.

• 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.

• Employs discretion and independent judgment to ensure compliance with state and federal law, and with established company, technical, and customer service best practices.

Qualifications:

• Four-year college degree or equivalent combination of education and experience required.

• Evidence of continuing education (i.e. industry designations) preferred.

• Ability to service claims of low, moderate, and higher complexity as normally acquired through 5-15 years’ experience.

• Litigation, investigation or SIU experience required.

• Strong strategic/critical thinking ability required.

• Multi line business experience desirable.

• 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 necessary.

• Advanced organization and planning recognition skills required.

• Advanced oral and written communication skills and interpersonal skills required.

• Valid driver's license with a level of financial responsibility required by the club and an acceptable motor vehicle record required for field positions.

Remarkable benefits:
• Health coverage for medical, dental, vision
• 401(K) saving plan with company match AND Pension
• Tuition assistance
• PTO for community volunteer programs
• Wellness program
• Employee discounts (membership, insurance, travel, entertainment, services and more!)

Auto Club Enterprises is the largest federation of AAA clubs in the nation. We have 14,000 employees in 21 states helping 17 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 1902, 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

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).

About the company

American Automobile Association is a federation of motor clubs throughout North America.

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