Senior MedPay Auto Claims Adjuster

AAA Auto Club Enterprises; Lincoln (RI); On-site; USD 50,000 - 66,000; Full time

Benefits offered by this job

Health coverage

401(k) + Pension

Tuition assistance

Floating holidays

Parental leave

Wellness programs

Employee discounts

Job summary

Auto Club Enterprises is seeking a Claims Senior Medpay Adjuster to handle moderate to high complexity auto claims, including liability evaluation, coverage interpretation, and negotiation. The role requires independent judgment to ensure compliance with state and federal laws and company guidelines.

Responsibilities include investigations, statements collection, claim value assessment, and supporting the claims process across multiple systems (CACS, HUON, HOC, GUIDEWIRE).

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 7-9 years of claims handling experience.
• 7-9 years Property, Auto, Casualty or relevant claims administration experience preferred.
• Knowledge of claims administration best practices and procedures.
• Advanced knowledge of Microsoft Office and claims software.

Responsibilities

• Communicate with insureds and claimants; explain benefits, coverages, fault, and claims process.
• Conduct phone investigations to determine liability and damages; obtain statements.
• Evaluate and determine claim values upon receipt and assessment of data.
• Negotiate within settlement authority to resolve claims.
• Update claim files and reports in company systems (CACS, HUON, HOC, GUIDEWIRE).
• Control expenses for areas of responsibility; coordinate with internal/external departments.
• Independently resolve claim exposures within authority.
• Respond to customer needs and problems; participate in legal proceedings if required.

Skills

Oral & written communication

Leadership

Interpersonal skills

Analytical thinking

Education

Bachelor's degree or equivalent

Tools

CACS

HUON

HOC

Guidewire

Microsoft Office

Job description

Auto Club Enterprises is seeking a Claims Senior Medpay Adjuster to handle moderate to high complexity auto claims, including liability evaluation, coverage interpretation, and negotiation. The role requires independent judgment to ensure compliance with state and federal laws and company guidelines.

Responsibilities include investigations, statements collection, claim value assessment, and supporting the claims process across multiple systems (CACS, HUON, HOC, GUIDEWIRE).