Job description
Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units. Resolve coverage questions, take statements and establish clear evaluation and resolution plans for claims.Our Auto Club Group Claim Specialist earns a competitive salary of $56,000- $78,000 to start along with the opportunity for an annual company bonus incentive.
Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim, and 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.
Employees assigned to Auto Physical Damage (“APD”) claim unit will handle moderately complex claims involving settling Total Losses, inspecting vehicles and preparing estimates of damage. If in the DRS Examiner role, manage Direct Repair Shops for compliance with our program. Additional responsibilities may include the following: determining cause of damage, establishing liability, identifying subrogation potential, monitoring repairs and approving car rental expense. May handle simple APD Litigation cases.
Employees assigned to a Recovery unit will complete recovery tasks on moderately complex claims for all lines of business. The tasks may not cover the entire lifecycle of a claim but will be an expansion of those aspects related to the financial recovery of funds previously paid on a claim from liable parties or other insurance carriers. Additional responsibilities may include the following: evaluating and presenting proofs to support both liability and damage decisions; applying knowledge of venues, negligence laws and case law associated with recovery for all states to determine handling strategies; participating in the arbitration process as an applicant, respondent-counter applicant and as an arbitrator rendering decisions on cases presented to Arbitration Forums; negotiating, settling and recovering receipts; ensuring that funds recovered are accounted for appropriately and settlements are maximized.
Qualifications
We’re looking for candidates who:
Education (include minimum education and any licensing/certifications):
- 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.
- Must have a valid State Driver's License
- One year of experience with:
- negotiating claim settlements
- securing and evaluating evidence
- preparing manual and electronic estimates
- subrogation claims
- resolving coverage questions
- taking statements
- establishing clear evaluation and resolution plans for claims
Knowledge and Skills:
Knowledge of:
- Essential Insurance Act (Michigan)
- Fair Trade Practices Act as it relates to claims
- subrogation procedures and processes
- intercompany arbitration
Knowledge of:
- Negligence Law
- No-Fault Law
- collision repair techniques
- 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 work load 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
Education:
- 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
IV. Work Environment
Works in a temperature controlled office environment. Depending on line frequent travel may be required to various repair facilities in order to conduct inspections/re-inspections, visit patients, hospitals, attorneys, rehabilitation centers, repair facilities, etc. per with exposure to road hazards and temperature extremes. For Homeowners and CAT may require deployment to territories impacted by storms.
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Long-term, sustainable, profitable growth
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AAA Membership growth and renewal
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Operational excellence
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Become the “flagship club” of the AAA Federation
Important Note:
ACG’s Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
The above statements describe the principle and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfil these requirements.
The Auto Club Group, and all of its affiliated companies, is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
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