Claim Specialist- Direct Repair Unit

AAA-The Auto Club Group

5d•$67,000 - $87,000•Remote

About The Position

This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Auto Physical Damage Specialist (Direct Repair Unit)– The Auto Club Group Reports to: Claim Manager II What you will do: (Primary Duties & Responsibilities) The Auto Club Group is seeking a Direct Repair 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 have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed. 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 Auto Physical Damage (“APD”) claim unit will handle complex claims involving settling Total Losses, inspecting vehicles and preparing estimates of damage. If in the DRS Examiner role, manage Direct Repair Shops for compliance with our program. Additional responsibilities may include the following: determining cause of damage, establishing liability, and identifying subrogation potential. Monitor repairs and approve car rental expense. Oversee APD Litigation cases. Manage the litigation process including attorney and budget management, participation in mediation activities and determining the appropriate settlement position. May assist Claim Manager with file reviews and training.

Requirements

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
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
collision 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

Nice To Haves

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 ProLevel training
CCC training
Xactware Training

Responsibilities

reviewing assigned claims
contacting the insured and other affected parties
setting expectations for the remainder of the claim process
initiating documentation in the claim handling system
Complete complex coverage analysis
Ensure all possible policyholder benefits are identified
Create additional sub-claims if needed
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
handle complex claims involving settling Total Losses, inspecting vehicles and preparing estimates of damage
manage Direct Repair Shops for compliance with our program
determining cause of damage
establishing liability
identifying subrogation potential
Monitor repairs and approve car rental expense
Oversee APD Litigation cases
Manage the litigation process including attorney and budget management, participation in mediation activities and determining the appropriate settlement position
May assist Claim Manager with file reviews and training