Personal Injury Protection Claims Examiner (SAN ANTONIO)
$57.97k - $97.82kUSAA
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful.
We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs.
The Opportunity
As a dedicated First Party Injury Adjuster- PIP/Med Pay you will be responsible to adjust non-attorney involved soft tissue bodily injury or auto PIP/MP medical claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge level of best-in-class member service through setting appropriate expectations, proactive communications, advice, and empathy.
This is a hybrid role requires an individual to be in the office 3 days per week . This position can be based in one of the following locations: San Antonio, TX, Phoenix, AZ Colorado Springs, CO, Chesapeake, VA or Tampa, FL. Relocation assistance is not available for this position.
Training Schedule: Hiring for July and August start dates. Must be available to attend mandatory training for 7 weeks. PTO will not be permitted during these time frames.
Work Schedule: Must be open and available to work any schedule assigned between Monday - Friday 7:00a.m - 7:30 p.m.
What you'll do:
- 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.
What you have:
- 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.
What sets you apart:
- 2 or more years Auto Liability/Casualty adjusting experience to include complex/multi vehicle liability.
- 3 or more years PIP/Med Pay coverage handling experience.
- Ongoing Professional Development with a focus on Insurance.
- Bachelors Degree or higher.
Compensation range: The salary range for this position is: $57,970 - $97,820 .
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include 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, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
$57.97k - $97.82k
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