Heavy Line Lead Claims Adjuster

The Lead AGA Claims heavy line Adjuster is responsible for determining covered failures by reviewing Heavy Duty Truck service agreements, interpreting contract coverage, determining the need for inspection, and researching all facts, for multiple product lines; including but not limited to Heavy Duty (Class 8) Trucks, automobiles, all heavy machine categories, recreational vehicles, and power sports. Contact with repair facilities, customers, and clients may include inbound/outbound communication via phone, email, fax, mail, or chat. This position reports to the Supervisor, AGA Claims of the center and receives varying levels of supervision depending on level within the AGA Claims Adjuster Job Family. ​

What will be my duties and responsibilities in this job? 

• Maintaining an extensive level of technical expertise for all heavy machine categories, this includes knowledge of the design and function of diesel, gas, and natural gas engines, manual, hydrostatic, automatic, planetary gear, splitter, and powershift transmissions, power transfer gearboxes, manually operated, pilot operated, servo operated and electronic controlled hydraulics systems, DEF systems, pneumatic systems, air conditioning systems, undercarriage systems, electrical systems, as well as digital electronics and hybrid electronics as these systems apply to all machine types.
• Respond to and resolve issues encountered by clients and customers in a timely and positive manner. When necessary, this involves inbound calls, outbound calls, email, fax, and chat.
• Execute effective processes to manage handling, data entry, and data integrity for all applicable claims.
• Research coverage verification, missing contracts, and other complex issues coming from the contact center, AEs, accounting, and other departments, and provide timely resolutions as well as suggestions to reduce those occurrences in the future.
• Ensure that all customer/client requests are responded to in a timely manner and any applicable meaningful solutions are proposed and implemented.
• Adhere to standards for effective job performance and development. 
• Partake in, and adhere to, training programs and quality assessment standards for effectiveness in supporting departmental goals and objectives and recommend improvements.  
• Actively participate in the development of personal performance management plans
• Maintain, advance, and share in-depth understanding of applicable AGA products, clients, systems, and applications.  
• Delegate or handle escalated issues as assigned by supervisor or management.
• Assist System Support Team as applicable with new or existing implementations including but not limited to testing, feedback, and design.
• Review coverage by utilizing all available tools, including contract and web-based applications, to resolve complex issues; and refer any issues as necessary to supervisor or management.
• Adjudicate claims with accuracy, by working directly with the repair facility, inspection and parts vendors, and multiple other resources as necessary, to ensure proper claims adjudication within departmental standards, and in accordance with applicable laws and contract provisions to ensure compliance with all Department of Insurance Regulations
• Document reasons for denial or authorization of claim in accordance with contract conditions, and quoting contract language, to the correct parties in a timely manner within authority level and seek approval when above authority.
• Ensure compliance with ISO, SOX, and other applicable internal and external audits and/or contractual obligations.
• Delegate and/or complete and manage unique projects essential to the department.

What are the requirements needed for this position? 

• High school diploma or GED
• Strong background in HD diesel engines
• Previous Experience in a Heavy Truck (Class 8) Repair Facility
• 5+ Years experience in the Heavy Truck service operations
• ASE medium/Heavy duty truck certification preferred
• Tech degree for medium/Heavy duty truck technology preferred

What other skills/experience would be helpful to have?  ​

• Applies advanced problem-solving skills to complex issues.
• Recognizes and recommends areas needing improvement.
• Excellent written and verbal skills to communicate with team members, management, customers, clients, service managers, fixed operations directors, counselors, and other empl