Accident Claims Adjuster IV
2 weeks ago
At American International Group (AIG), we are transforming the way we assist our clients in managing risk. As a Senior Claims Specialist in Accident & Health, you will be an integral part of this evolution, enhancing your skills and expertise as a valued team member.
Your Role in Accident and Health Claims
Our Claims teams are recognized as the premier problem solvers for our clients, consistently delivering technical excellence and showcasing our service differentiation to create an unmatched global claims handling experience. We pride ourselves on providing responsive, fair, and professional service, characterized by empathy and efficiency, supported by a robust feedback mechanism and strong leadership.
Key Responsibilities
- Manage all aspects of claim resolution for assigned cases while ensuring exceptional service to both external and internal clients.
- Verify coverage of claims by examining policies and documentation submitted for complex claims.
- Evaluate coverage and communicate the coverage position, including managing key stakeholders such as brokers, underwriting partners, and policyholders.
- Conduct and oversee investigations into loss facts.
- Assess eligibility of claims and determine amounts owed under the policy terms.
- Identify and pursue subrogation opportunities when applicable.
- Make appropriate referrals for Risk and Fraud as necessary.
- Handle high-severity and technical losses with minimal supervision, including performance guarantee accounts and litigation matters.
- Process Accidental Death & Dismemberment claims accurately and promptly.
- Support team development through mentoring and conducting file audits.
- Assist management with stakeholder engagement, including client stewardship meetings and addressing customer escalations.
- Interpret insurance policies and liaise with Underwriting, as well as interact regularly with legal counsel.
- Foster an innovative mindset to drive process improvements.
- Perform other duties as assigned.
- Highly organized with the ability to thrive in a fast-paced, team-oriented environment.
- Minimum of 5 years of insurance claims experience, particularly in Accident and Health claims, including sickness and bodily injury claims or related complex risk handling.
- Exceptional customer service skills with the capability to manage response timelines and reporting requirements.
- Strong computer and organizational skills.
- Excellent written and verbal communication skills, with the ability to handle customer appeals effectively.
- Proficient in reading and interpreting insurance policies and acting as a liaison with Underwriting.
- Ability to mentor and develop team members.
- Accident and Health State Adjuster licenses are advantageous and will be required post-hire.
- Bilingual capabilities (Spanish) are a plus.
At AIG, our employees are our most valuable asset. We understand the importance of protecting and investing in what matters most to you. That’s why we offer a comprehensive Total Rewards Program that focuses on your health, wellbeing, financial security, and professional development, providing peace of mind for you and your family.
Our Commitment to Inclusion
We are dedicated to fostering a culture that respects and celebrates the diverse talents, backgrounds, and perspectives of our employees. Our flexible work arrangements, diversity and inclusion initiatives, and Employee Resource Groups (ERGs) contribute to a culture of belonging. The diversity of our workforce is one of AIG's greatest strengths, and we are proud to have received recognition for our commitment to positive change.
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