Claim Representative II
- Traverse City, MI
Claim 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.
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