Florida Claim Customer Service Representative

AAA-The Auto Club Group•Tampa, FL

1d•$20 - $23•Hybrid

About The Position

The Auto Club Group is seeking a Florida Claim Customer Service Representative who will be responsible for taking first notice of loss, handling claim inquiries, initiating claim services and handling low-complexity, one-touch claims in a call center environment. In this position, you will have the opportunity to identify non-complex claims for one-touch claim adjudication upon intake. Determine the type and extent of loss and ensures the claim is consistent with all reported facts. Review necessary legal and police/fire reports to process claims as necessary. Interpret policy language and applies coverage to authorize or deny claims. Initiate services, authorizes, and resolve issues related to services such as car rental and vehicle repairs and non-complex homeowner claims (e.g., food spoilage). Initiate and create payments, settles, or recommend settlement value of claims within specified limits. Identify additional claim exposures and create sub-claims as necessary. Refer files for investigation as warranted. Inform insured of coverage decision on claims within defined scope. Respond to claimant inquiries and explains payments. Document claim files. Review the status of open and closed reserves and makes adjustments consistent with exposures. Identify claims for salvage and subrogation potential in accordance to company policy. Close claims in a timely manner. Ensure compliance with state regulations. Handles inbound claim inquiries received via phone, the ACG website and other sources. Explain the benefits of company programs to customers, and initiates services, such as arranging for repair inspections, vehicle tows and car rental. Provide basic information to members regarding claims procedures in accordance with Customer Interaction Model. Promote customer satisfaction and provide seamless service to ensure customer service goals and standards are met. Navigate through various sources of information and claim processing systems (E.g., FACTS, CPS, Point of Sale, IPM insurance systems, Intranet/Internet, and manuals). Respond to members/customers questions in a timely manner. With our powerful brand and the mentoring, we offer, you will find your position as a Florida Claim Customer Service Representative can lead to a rewarding career at our growing organization.

Requirements

High School Diploma or equivalent
Completion of AAA approved call center training program, appropriate level ACG Claim Representative Training program and ongoing training and certification for the position
Must have an active Florida State Adjuster License
Processing information and handling claim inquiries utilizing PCs and software packages (e.g. ACG claim systems, Microsoft Word, Excel)
Reading and comprehending various Customer Care service tools (manuals, work models, etc.)
Performing mathematical calculations including adding, subtracting, percentages, etc.
Analyzing and resolving problems
A claim related field such as insurance, automotive, medical or legal services
A call center environment
Utilizing ACG automated systems
Investigating and resolving claims related problems
Handling claims or claim support tasks such as processing glass claims, car rentals, invoice payments, etc.
Knowledge of: Claim processing policy and procedures
General claim processing functions
Claim processing systems
Telephone etiquette
ACG insurance processes and procedures
Auto and home repair basics and cost estimating
State insurance laws
Regulatory compliance requirements
Property and casualty insurance policy language and provisions
Claims quality service standards
Liability, negligence, No-Fault principles and subrogation
Ability to provide a high level of customer service
Strong interpersonal skills demonstrated through work experience, participation in extra-curricular activities and/or community involvement
Strong communication skills required in understanding customers’ concerns and to provide high-quality customer service as demonstrated through the effective use of the customer care call center model
Excellent verbal communication skills service
Strong written communications skills (example may be required at time of interview) needed to respond in a professional manner to members/customers inquiries
Effective listening skills
Ability to learn and apply claim handling skills, including: Policy analysis and coverage application
Claim payment coding, issuance, and exception handling
Proactive customer contact and issue resolution
Car rental coverage knowledge
Claims’ related policies and procedures
Auto and home repair estimate basics and compliance review
State compliance requirements
Subrogation identification and referral
Understand insurance fraud scenarios and recognize potential fraud indicators
Issue written correspondence
Prioritize claims-related functions
Willingness and ability to work irregular shifts, including weekends and holidays
Must reside within 50 miles from our Tampa Florida Location

Nice To Haves

Completion of AAA approved call center training program, appropriate level ACG Claim Representative Training program and ongoing training and certification for the position
Processing information and handling claim inquiries utilizing PCs and software packages (e.g. ACG claim systems, Microsoft Word, Excel)
Reading and comprehending various Customer Care service tools (manuals, work models, etc.)
Performing mathematical calculations including adding, subtracting, percentages, etc.
Analyzing and resolving problems
A claim related field such as insurance, automotive, medical or legal services
A call center environment
Utilizing ACG automated systems
Investigating and resolving claims related problems
Handling claims or claim support tasks such as processing glass claims, car rentals, invoice payments, etc.
Knowledge of: Claim processing policy and procedures
General claim processing functions
Claim processing systems
Telephone etiquette
ACG insurance processes and procedures
Auto and home repair basics and cost estimating
State insurance laws
Regulatory compliance requirements
Property and casualty insurance policy language and provisions
Claims quality service standards
Liability, negligence, No-Fault principles and subrogation
Ability to provide a high level of customer service
Strong interpersonal skills demonstrated through work experience, participation in extra-curricular activities and/or community involvement
Strong communication skills required in understanding customers’ concerns and to provide high-quality customer service as demonstrated through the effective use of the customer care call center model
Excellent verbal communication skills service
Strong written communications skills (example may be required at time of interview) needed to respond in a professional manner to members/customers inquiries
Effective listening skills
Ability to learn and apply claim handling skills, including: Policy analysis and coverage application
Claim payment coding, issuance, and exception handling
Proactive customer contact and issue resolution
Car rental coverage knowledge
Claims’ related policies and procedures
Auto and home repair estimate basics and compliance review
State compliance requirements
Subrogation identification and referral
Understand insurance fraud scenarios and recognize potential fraud indicators
Issue written correspondence
Prioritize claims-related functions

Responsibilities

Taking first notice of loss
Handling claim inquiries
Initiating claim services
Handling low-complexity, one-touch claims in a call center environment
Identify non-complex claims for one-touch claim adjudication upon intake
Determine the type and extent of loss and ensures the claim is consistent with all reported facts
Review necessary legal and police/fire reports to process claims as necessary
Interpret policy language and applies coverage to authorize or deny claims
Initiate services, authorizes, and resolve issues related to services such as car rental and vehicle repairs and non-complex homeowner claims (e.g., food spoilage)
Initiate and create payments, settles, or recommend settlement value of claims within specified limits
Identify additional claim exposures and create sub-claims as necessary
Refer files for investigation as warranted
Inform insured of coverage decision on claims within defined scope
Respond to claimant inquiries and explains payments
Document claim files
Review the status of open and closed reserves and makes adjustments consistent with exposures
Identify claims for salvage and subrogation potential in accordance to company policy
Close claims in a timely manner
Ensure compliance with state regulations
Handles inbound claim inquiries received via phone, the ACG website and other sources
Explain the benefits of company programs to customers, and initiates services, such as arranging for repair inspections, vehicle tows and car rental
Provide basic information to members regarding claims procedures in accordance with Customer Interaction Model
Promote customer satisfaction and provide seamless service to ensure customer service goals and standards are met
Navigate through various sources of information and claim processing systems (E.g., FACTS, CPS, Point of Sale, IPM insurance systems, Intranet/Internet, and manuals)
Respond to members/customers questions in a timely manner
Successfully complete at least one of the following within 9 months of hire: AAA general claim policy training. Policy, negligence, and no-fault training
Proactively contact and effectively interact with the public and business partners through outbound communication
Work independently
Communicate effectively over the telephone
Work under pressure
Record and maintain information accurately and in a timely fashion
Work effectively in a team environment
Sit for the majority of the workday