APD Claim Representative I - Meemic

AAA The Auto Club Group is seeking a Claim Representative I who will handle basic, entry-level claims under close supervision. The role involves reviewing claims, contacting insured parties, conducting investigations, and documenting claims in the management system.

Responsibilities

• Review assigned claims
• Contact the insured and other affected parties, set expectations for the remainder of the claim, and initiate documentation in the claim handling system
• Complete a general 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
• Make referrals 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
• Determine liability issues, injuries or other factors require reassignments of the claim
• Contact the insured to verify and gather accident and damage facts to determine the appropriate method of inspecting the vehicle
• Review vehicle repair estimates to understand the value of damages applicable to the claim
• Monitor and approve care rental expenses
• Obtain and review police reports and other vehicle or accident related documents as part of the claim investigation
• Monitor vehicle repair status and interact with DRS shops and Claims DRS Examiners when needed to resolve and communicate claims status and issues

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
• 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
• Six months of experience with: Negotiation of claim settlements, Securing and evaluating evidence, Preparing manual and electronic estimates, Subrogation claims
• Basic knowledge of: Essential Insurance Act (Michigan), Fair Trade Practices Act as it relates to claims, Subrogation procedures and processes, Intercompany arbitration
• Basic knowledge of: Negligence Law, No-Fault Law, Collision repair techniques
• 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 research analyze and interpret subrogation laws in various states
• Ability to work evenings or weekends

Benefits

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

Company Overview