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Claim Representative II - Homeowners Desk Adjuster

Company: The Auto Club Group
Location: Dearborn
Posted on: January 8, 2021

Job Description:

Job DescriptionClaim Representative II - The Auto Club Group What you will do: The Auto Club Group is seeking prospective Claim Representative II who can 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.In this position, you will have the opportunity to: 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 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) and up to $100,000 (for field 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.With our powerful brand and the mentoring we offer, you will find your position as a Claims Representative II can lead to a rewarding career at our growing organization. How you will benefit: 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

QualificationsWe're looking for candidates who: 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 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: 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 Ability to: Lift up to 25 pounds Climb ladders Walk on roofs What it's like to work for us: We serve our members by making their satisfaction our highest priority. We do what's right by sustaining an open, honest and ethical work environment. We lead in everything we do by offering best-in-class products, benefits and services. And we value our employees by seeking the best talent, rewarding high performance and holding ourselves accountable. All in all, we create an inclusive and welcoming environment of diverse backgrounds, experiences and viewpoints, realizing our differences make us stronger. Who we are: The Auto Club Group helps AAA Members enjoy life's journey with peace of mind by providing innovative solutions, advocacy and membership benefits wherever and whenever they need them. We currently conduct business in 13 states in the upper Midwest and the Southeast. The Auto Club Group has established four long-term enterprise goals: Long-term, sustainable, profitable growth AAA Membership growth and renewal Operational excellence Become the "flagship club" of the AAA Federation Important Note: 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. Category: Insurance , Keywords: Insurance Examiner

Keywords: The Auto Club Group, Dearborn , Claim Representative II - Homeowners Desk Adjuster, Other , Dearborn, Michigan

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