• Evaluate and analyze documentation for claim payments or denials according to the policy/certificate provisions and state regulations, with increased authority limits. • Analyze information/documentation received to determine how to proceed with a review of a claim and determine methods of obtaining additional information from alternative sources. • Manage the review of a claim and outside sources used in the review. • Document correspondence and conversations. • Correspond verbally and in writing with claimants, medical providers, medical examiners, and law enforcement. • Work closely with department manager, legal counsel, medical director, claims assistants, and other departments to gather information for contested claims. • Monitor claims for fraud and proceed according to each situation, such as engaging the Fraud team or conducting additional research. • Maintain compliance with regulations. • May testify in depositions, hearings and trials; communicate the Company’s position regarding the claim. • Assist peers with processing questions in the absence of higher level staff. • May serve as a back up to review and authorize pending payments calculated by peers, within approval authority.

Claims Senior Casualty Adjuster Job Summary The Claims Senior Casualty Adjuster handles moderate to high complexity claims involving material damage, property and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include liability investigation, coverage evaluation, negotiation strategies and claims resolution of moderate to high 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. Under general supervision, works within specific limits of authority to resolve claims. Job Duties - 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. - 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. Recognize and appropriately address moderate complexity coverage issues. - Evaluate and determine claim values upon receipt and assessment of property, bodily injury and liability data. - Negotiate within settlement authority with insureds and claimants to resolve first and third party claims. - Update database production reports, and document and update claim files via company systems, i.e. CACS, HUON, HOC, 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. - Respond quickly to customer needs and problems. - Independently resolve claims within authority level. Qualifications - Bachelors Equivalent combination of education and experience Preferred - 7-9 years Prior claims handling experience. Preferred - 4-6 years Property, Auto, Casualty or relevant claims administration experience. Required - Comprehensive knowledge of claims administration best practices and procedures. - Advanced knowledge of insurance, fault assessment, negligence and subrogation principles required. - Comprehensive understanding of building and vehicle repair procedures and third-party liability issues. - Advanced knowledge of Microsoft Office suite, general computer software and claims software. - Advanced organization and planning recognition skills required. - Advanced oral and written communication skills required. - Advanced interpersonal skills required. - Advanced leadership skills among peers required. - Exhibit proficiency and understanding of medical terminology and causality - Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required - Chartered Property Casualty Underwriter - Insurance Institute of America Preferred - Associate in Claims - Insurance Institute of America Preferred - An insurance/claims adjuster license may be required for claims administration in specific states. Travel Requirements - Occasional travel to business meetings or conferences. The starting pay range for this position is: $38.64 - $51.46Additionally, for full time positions, 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!) Auto Club Enterprises is the largest club within the national AAA federation. We have nearly 17,000 employees in 24 states helping more than 18 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 1900, 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 Our organization participates in E-Verify 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).

• Investigate & Resolve Claims: Assess and resolve auto claims with moderate supervision, focusing on coverage, liability, and damages. • Judgment & Decision-Making: Use sound judgment to determine exposure and the best course of action. • Cost Control: Minimize claims costs and expenses while ensuring a positive experience for policyholders. • Collaboration: Interact extensively with various parties involved in the claim process. • Process Improvement: Identify and implement ways to boost efficiency and effectiveness. • Timely Documentation: Clearly record and communicate claims activity for smooth resolution.

• Determine compensability and/or coverage issues for loss time workers' compensation claims. • Effectively manage a caseload of loss time claims from numerous jurisdictions. • Negotiate and direct settlements under management's review. • Gather medical and factual evidence to determine compensability. • Direct outside investigation and handle litigation files within given authority. • Coordinate and maintain contact with claimants and/or their attorneys, outside investigators, and rehabilitation personnel as well as routine contact with insureds, account liaisons and medical providers.