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Job Type:
Full timeExempt/Non Exempt:
SalaryJob Description:
Claim Representative II - Homeowner CAT Desk – Auto Club Group
What you will do:
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.
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 Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role). Investigate claims requiring coverage analysis. When handling claims in the field, must prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status and updates.
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.
Supervisory Responsibilities (briefly describe, if applicable, or indicate None):
None
How you will benefit:
Claim adjusters will earn a competitive salary of $62, 233- $74,000 annually with CAT Pay and annual bonus potential based on performance.
Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include:
401k Match
Medical
Dental
Vision
PTO
Paid Holidays
Tuition Reimbursement
Required Qualifications (these are the minimum requirements to qualify)
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
Experience:
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 building construction and 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 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
Preferred Qualifications
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
Xactware Training
Ability to:
lift up to 25 pounds
climb ladders
walk on roofs
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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Who We Are
Become a part of something bigger.
The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life’s journey through insurance, travel, financial services, and roadside assistance.
And when you join our team, one of the first things you’ll notice is that same, whole-hearted, enthusiastic advocacy for each other.
We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.
To learn more about AAA The Auto Club Group visit www.aaa.com
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 principal 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 fulfill these requirements.
The Auto Club Group, and all 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.
Regular and reliable attendance is essential for the function of this job.
AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.