Claim Representative – Inside Catastrophic Unit
The Auto Club Group (ACG) provides membership, travel, insurance and financial services offerings to approximately 9 million members and customers across 11 states and 2 U.S. territories through the AAA, Meemic and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
Primary Duties and Responsibilities (details of the basic job functions):
Independently perform detailed and highly complex claim functions. Review files, obtain coverage information and contact insured to discuss claim process, provide emergency funds, etc. Explain laws/regulations regarding home repair. Arrange for vehicle/home inspections, alternate transportation/living expenses, etc. Inspects property and prepares estimate or works with direct repair facilities to obtain necessary information. Analyze damage and determines whether to repair or replace damaged parts. Recommends usage of aftermarket parts for non-safety related items. Obtain necessary medical, accident, legal and police reports to complete files. Work with insured to select contractor as needed. Arrange for repair or cleaning of salvageable items. Ensure the sale of salvage to reduce claim costs. Notify insured of total loss and advises regarding procedures. Authorize repairs and update claim diary. Review the status of open and closed reserves and makes adjustments consistent with exposures. Authorize checks within authority level. Review files for potential subrogation and complete subrogation forms. Assist in the recovery of corporate claim expenditures from insureds/applicants, uninsured motorists, businesses, other insurers, etc. in accordance with established procedures. May represent company at trials, depositions and settlement hearings. Assist less experienced claim representatives with claims that are more complicated and complex. Assume responsibility for complex files that were previously assigned to other claim representative(s) and/or technical support staff members. Participate in Branch Settlement Support Council Meetings and visit assigned branches and legal department to assist in structured settlement utilization as necessary. Provides after-hour coverage to process claims on a rotating basis.
- Associate's 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.
- ADP and Pen-Pro training.
- Subrogation experience in a property/casualty insurance company.
- Strong negotiation skills.
Experience to include:
- Analyzing and problem solving
- Organization and planning
- Decision making
- Investigating, evaluating and settling homeowners claims including accurately preparing construction damage estimates
- Inspecting and evaluating construction repairs for quality and compliance with repair estimates
- Coordination and collection of data to handle subrogation opportunities on multiple claims from one event
- Basic PC software skills (Word, Excel etc.)
Works in a temperature controlled office environment.
Required Qualifications (these are the minimum requirements to qualify):
- 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.
- Experience as a Claim Representative, a Public or Private Investigator, or equivalent or a minimum of one year experience as a Claim Associate within identified area (e.g. Casualty, auto physical damage, homeowners). Applicants selected from the Claim Associate candidate pool must successfully complete all training required within nine (9) months of hire.
Experience in the investigation, evaluation and settlement of claims to include:
- Homeowner medical and BI
- Homeowner property claims
- Subrogation claims
Experience to include :
- Evaluating construction repairs for quality and compliance with repair estimates
- Third party collections
- Complex claim investigations
- Negotiation of claim settlements
Investigation experience to include:
- Securing and evaluating evidence
- Determining the existence of possible criminal actions
- Assisting in the preparation of court proceedings
Knowledge to include:
- Negligence Law
- No-Fault Law
- Essential Insurance Act
- The Fair Trade Practices Act as they relate to claims
- Building construction and repair techniques
- Criminal law
- Court procedures
- Subrogation procedures and processes
- Intercompany arbitration
Demonstrated skill in:
- Organization and planning
- Analyzing and problem solving
- Written communications to include record keeping and report preparation
- Use automated processing and computer systems, including basic PC software skills
- Effectively respond to questions/concerns
- Communicate effectively with others in a work environment, with the Public, law enforcement personnel and vendors
- Develop and conduct training programs on fraud detection in all lines of coverage
- Provide technical expertise to Claims department on suspected insurance fraud
- Independently perform detailed and highly complex injury claim negotiations
- Process time sensitive data and information from multiple sources
- Make decisions based on data
- Communicate decisions to a broad audience
- Research analyze and interpret subrogation laws in various states
- Prioritize work
- Work under pressure to meet deadlines
- Willingness to travel outside of assigned territory which may involve overnight stay.
- Willingness to relocate, work evenings or Saturdays.
- Valid State Driver's License.
The Auto Club Group offers a competitive compensation and benefits packages including a base salary with performance based incentives; medical/dental/vision insurance, pension, 401(k), generous time off, a complimentary AAA Membership and much more!
Important Note: 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 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.
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