Associate Claims Examiner

Costa Mesa, California

 
Associate Claims Examiner

This position is responsible for the review of high exposure claim files to ensure reserves are properly set and maintained, demands are handled appropriately and regulatory standards are adhered to for compliance. Subject matter expert in all disciplines. Provides guidance to ACE markets for the handling, strategy and conclusion of complex claims files. Supports the Claims business unit by providing a comprehensive level of technical support and assistance. Demonstrates discretion when assessing complex and unique claims.

Responsibilities:

  • Reviews and authorizes claim reserves and provides settlement recommendations. Provides direction to claims personnel and counsel on complex claims files.

  • Reviews claim files to ensure completeness, timeliness and member service guidelines are being adhered to for compliance.

  • Provides management with recommendations and guidance regarding coverage to ensure the Exchange is protected against risk.

  • Ensures accurate diaries are established and maintained and provides guidance in litigation strategy to monitor expenses.

  • Analyzes and reports patterns and trends to upper management and may be involved in extra contractual cases. Based on trends may provide training and insight to claims and legal personnel.

  • Conducts annual audits as directed by senior management.

Education:

  • BA/BS or equivalent combination of education and experience required.

  • Continuing education through attainment of industry designations highly desirable.

Typical Experience:

  • 5 years of an expert level of claims technical experience within a related specialized area

  • 2-3 years with Club experience is preferred

Knowledge/Skills/Competencies:

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

  • Advanced organization and planning skills necessary

  • Advanced oral and written communication skills required

  • Advanced interpersonal skills required

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

The Automobile Club of Southern California is part of the largest federation of AAA clubs in the nation. We have 14,000 employees in 21 states helping 17 million members. 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.