USAA is a company dedicated to empowering its members to achieve financial security. The Injury Adjuster- FPI will be responsible for adjusting soft tissue bodily injury or auto PIP/MP medical claims, ensuring compliance with state laws, and delivering exceptional member service.
Responsibilities
- Adjusts soft tissue, moderately complex and complex 1st party PIP/MP medical claims
- Identifies, confirms, and makes coverage decisions on soft tissue claims
- Investigates loss details, determines legal liability, evaluates, negotiates, and adjudicates claims appropriately and timely; within appropriate authority guidelines with clear documentation to support accurate outcomes
- Provides advice and sets expectations into next steps to members
- Collaborates and supports team members to resolve issues and identify appropriate matters for escalation
- Partners with and/or directs vendors and internal business partners to facilitate timely claims resolution
- Delivers a best-in-class member service experience through setting appropriate expectations and proactive communication
- Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours
- May be assigned CAT deployment travel with minimal notice during designated CATs
- Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed
- Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled
Skills
- High School Diploma or General Equivalency Diploma
- 1 year of injury adjusting or auto liability adjusting experience to include highly complex vehicle physical damage, such as multi-vehicle, non-owned vehicles, or total loss claims
- Working knowledge and understanding of the auto claims contract, investigation, evaluation, negotiation, and accurate adjudication of claims as well as application of case law and state laws and regulations
- Demonstrated negotiation, investigation, communication, and conflict resolution skills
- Proven investigatory, prioritizing, multi-tasking, and problem-solving skills
- Exercise sound financial judgment and discretion in handling insurance claims
- Knowledge of coverage evaluation, loss assessment, and loss reserving
- Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts
- 2+ years Auto Liability/Casualty adjusting experience to include complex/multi vehicle liability
- 3+ years PIP/MedPay coverage handling experience
- Ongoing Professional Development with a focus on Insurance
- Bachelors Degree or higher
Benefits
- Comprehensive medical, dental and vision plans
- 401(k)
- Pension
- Life insurance
- Parental benefits
- Adoption assistance
- Paid time off program with paid holidays plus 16 paid volunteer hours
- Various wellness programs
- Career path planning and continuing education
Company Overview
USAA is a financial services company. It was founded in 1922, and is headquartered in San Antonio, Texas, USA, with a workforce of 10001+ employees. Its website is https://www.usaa.com.
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