Claim Specialist - Bodily Injury

AAA-The Auto Club Group

10d•$75,000 - $95,000•Remote

About The Position

Claim Specialist – Bodily Injury – The Auto Club Group Reports to: APD Claim Manager I What you will do: (Primary Duties & Responsibilities) ACG is seeking a prospective Claim Specialist to work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims In this position, you will: Handle highly complex new and reassigned auto and homeowner bodily injury liability claims. Adhere to ACG claim handling procedures, processes and guidelines. Complete coverage and liability investigations, including obtaining statements from involved parties. Obtain required documents and reports to complete coverage and liability investigations. Set expectations, ensuring the claim process is explained and understood. Complete complex coverage analysis. Identify additional exposures, create appropriate referrals for additional claims and subclaims. Conduct thorough reviews of liability, damages, and the applicability of state law. Evaluate settlement range value, prepare documents related to reserve, settlement and settlement authority. Negotiate settlements with attorney represented and non-represented parties. Utilize strong negotiation skills. Prepare legal releases. Authorize expense and indemnity payments. Complete referrals, when required, to underwriting, recovery, CSIU, large loss unit and HRCC. Document claim file memos, upload documents to claim file, complete claim coding. Present claim matters during meetings. Collaborate with legal team. Provide peer mentoring. Assist Management with special reports, projects, task. Handling policies within the following States: Illinois, Indiana, Georgia and/or Tennessee With our powerful brand and the mentoring, we offer, you will find your position as a Claims Specialist can lead to a rewarding career at our growing organization.

Requirements

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
Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge
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
Three years of experience or equivalent training in the following: negotiation of 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
Advanced knowledge of: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims subrogation procedures and processes intercompany arbitration handling simple litigation Negligence Law No-Fault Law medical terminology and human anatomy
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 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

Responsibilities

Handle highly complex new and reassigned auto and homeowner bodily injury liability claims.
Adhere to ACG claim handling procedures, processes and guidelines.
Complete coverage and liability investigations, including obtaining statements from involved parties.
Obtain required documents and reports to complete coverage and liability investigations.
Set expectations, ensuring the claim process is explained and understood.
Complete complex coverage analysis.
Identify additional exposures, create appropriate referrals for additional claims and subclaims.
Conduct thorough reviews of liability, damages, and the applicability of state law.
Evaluate settlement range value, prepare documents related to reserve, settlement and settlement authority.
Negotiate settlements with attorney represented and non-represented parties.
Utilize strong negotiation skills.
Prepare legal releases.
Authorize expense and indemnity payments.
Complete referrals, when required, to underwriting, recovery, CSIU, large loss unit and HRCC.
Document claim file memos, upload documents to claim file, complete claim coding.
Present claim matters during meetings.
Collaborate with legal team.
Provide peer mentoring.
Assist Management with special reports, projects, task.
Handling policies within the following States: Illinois, Indiana, Georgia and/or Tennessee