APD Claim Representative II - Michigan

AAA The Auto Club Group is seeking an Auto Claim Representative II who will handle moderately complex claims within Claim Handling Standards. The role involves resolving coverage questions, taking statements, and establishing clear evaluation and resolution plans for claims, while also conducting thorough reviews and documentation of claims.ResponsibilitiesReviewing assigned claimsContacting the insured and other affected partiesSetting expectations for the remainder of the claimInitiating documentation in the claim handling systemComplete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported lossEnsure all possible policyholder benefits are identifiedCreate additional sub-claims if needed or refer complex claims to management or the appropriate claim handlerComplete 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 potentialConduct thorough reviews of damages and determine the applicability of state law and other factors related to the claimEvaluate the financial value of the lossApprove payments for the appropriate parties accordinglyRefer 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 systemUtilize strong negotiating skillsHandle claims to the line Claim Handling StandardsFollow and apply ACG Claim policies, procedures and guidelinesWork within assigned ACG Claim systems including basic PC softwarePerform basic claim file review and investigationsDemonstrate 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 concernsAnalyze and solve problems while demonstrating sound decision making skillsPrioritize claim related functionsProcess time sensitive data and information from multiple sourcesManage time, organize and plan workload and responsibilitiesSafely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etcResearch analyze and interpret subrogation laws in various statesTravel outside of assigned territory which may involve overnight stayRelocate, work evenings or weekendsStrong negotiating skillsSkillsComplete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experienceIn 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 statesA valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with membersOne 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 claimsKnowledge 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 techniquesAbility 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 skillsAssociate degree in Business Administration, Insurance or a related field or the equivalent in related work experienceCompletion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalentCPCU coursework or designationI-Car 2000 trainingCCC trainingXactware TrainingBenefits401k MatchMedicalDentalVisionPTOPaid HolidaysTuition ReimbursementCompany OverviewAAA - The Auto Club Group (ACG) is the second largest AAA club in North America, serving more than 13+ million members across 14 U.S. It was founded in 1901, and is headquartered in Dearborn, MI, US, with a workforce of 5001-10000 employees. Its website is http://aaa.com.



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