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AAA-The Auto Club Group · 11 hours ago

Auto Claim Representative II

Dearborn, MI

Full-time

Hybrid

Entry, Mid Level

$55K/yr - $78K/yr

1+ years exp

AAA The Auto Club Group is seeking an Auto Claim Representative II who works under normal supervision with an intermediate-level approval authority to handle moderately complex claims. The role involves reviewing claims, contacting insured parties, conducting investigations, and ensuring compliance with claim handling standards.

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

Qualification

Negotiating claim settlementsSubrogation claimsCoverage analysisInsurance knowledgeClaims management systemEffective communicationCustomer service skillsBasic PC softwareProblem-solving skillsTime managementNegotiating skills

Required

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

One year of experience with securing and evaluating evidence

One year of experience with preparing manual and electronic estimates

One year of experience with subrogation claims, including identifying recovery opportunities

One year of experience with resolving coverage questions

One year of experience with taking statements

One year of experience with establishing clear evaluation and resolution plans for claims

Knowledge of Essential Insurance Act (Michigan)

Knowledge of Fair Trade Practices Act as it relates to claims

Knowledge of subrogation procedures and processes

Knowledge of intercompany arbitration/dispute resolution

Knowledge of Negligence Laws and Statutes

Knowledge of No-Fault Law and No-Fault Reform

Knowledge of Collision repair techniques

Ability to handle claims to the line Claim Handling Standards

Ability to follow and apply ACG Claim policies, procedures and guidelines

Ability to work within assigned ACG Claim systems including basic PC software

Ability to perform basic claim file review and investigations

Ability to demonstrate effective communication skills (verbal and written)

Ability to demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns

Ability to analyze and solve problems while demonstrating sound decision making skills

Ability to prioritize claim related functions

Ability to process time sensitive data and information from multiple sources

Ability to manage time, organize and plan workload and responsibilities

Ability to safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc

Ability to research analyze and interpret subrogation laws in various states

Ability to travel outside of assigned territory which may involve overnight stay

Ability to relocate, work evenings or weekends

Strong negotiating skills