Claim Representative II - APD

AAA The Auto Club Group is seeking an Auto Claim Representative II to handle moderately complex claims within Claim Handling Standards. The role involves reviewing claims, conducting investigations, and ensuring appropriate payments are made while maintaining strong communication with insureds and claimants.

Responsibilities

• Reviewing assigned claims
• Contacting the insured and other affected parties
• Setting expectations for the remainder of the claim
• Initiating documentation in the claim handling system
• Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss
• Ensure all possible policyholder benefits are identified
• Create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler
• Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential
• Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim
• Evaluate the financial value of the loss
• Approve payments for the appropriate parties accordingly
• Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit)
• Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system
• Utilize strong negotiating skills
• Handle claims to the line Claim Handling Standards
• Follow and apply ACG Claim policies, procedures and guidelines
• Work within assigned ACG Claim systems including basic PC software
• Perform basic claim file review and investigations
• Demonstrate effective communication skills (verbal and written)
• Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
• Analyze and solve problems while demonstrating sound decision making skills
• Prioritize claim related functions
• Process time sensitive data and information from multiple sources
• Manage time, organize and plan workload and responsibilities
• Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc
• Research analyze and interpret subrogation laws in various states
• Travel outside of assigned territory which may involve overnight stay
• Relocate, work evenings or weekends
• Strong negotiating skills

Skills

• Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
• In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states
• A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members
• One year of experience with: negotiating claim settlements securing and evaluating evidence preparing manual and electronic estimates subrogation claims, including identifying recovery opportunities resolving coverage questions taking statements establishing clear evaluation and resolution plans for claims
• Knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims subrogation procedures and processes intercompany arbitration/dispute resolution Negligence Laws and Statutes No-Fault Law and No-Fault Reform Collision repair techniques
• Ability to: handle claims to the line Claim Handling Standards follow and apply ACG Claim policies, procedures and guidelines work within assigned ACG Claim systems including basic PC software perform basic claim file review and investigations demonstrate effective communication skills (verbal and written) demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns analyze and solve problems while demonstrating sound decision making skills prioritize claim related functions process time sensitive data and information from multiple sources manage time, organize and plan workload and responsibilities safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. research analyze and interpret subrogation laws in various states travel outside of assigned territory which may involve overnight stay relocate, work evenings or weekends strong negotiating skills
• Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
• Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent
• CPCU coursework or designation
• I-Car 2000 training
• CCC training
• Xactware Training

Benefits

• 401k Match
• Medical
• Dental
• Vision
• PTO
• Paid Holidays
• Tuition Reimbursement

Company Overview