Michigan Claim Customer Service Representative

Auto Club Group • Troy, MI

3d • Remote

About The Position

This role is for a Michigan Claim Customer Service Representative at AAA The Auto Club Group. The position is full-time and hourly. Attendance is mandatory during the initial 90-day training and probationary period, and absences, tardiness, or early departures may impact continued employment. Candidates must be able to meet these attendance expectations and live within 50 miles of Dearborn, Michigan. The representative will be responsible for taking the first notice of loss, handling claim inquiries, initiating claim services, and managing low-complexity, one-touch claims in a call center environment. This includes identifying non-complex claims, determining the extent of loss, reviewing reports, interpreting policy language, authorizing or denying claims, initiating services like car rental and repairs, authorizing and issuing payments, identifying additional claim exposures, referring files for investigation, informing insureds of coverage decisions, responding to claimant inquiries, explaining payments, reviewing reserves, and identifying salvage and subrogation potential. The role also involves ensuring compliance with state regulations, completing first notice of loss for all policy products, explaining company programs, providing basic information on claims procedures, promoting customer satisfaction, and navigating various information sources and claim processing systems. The position does not have supervisory responsibilities.

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 be eligible to acquire and maintain a state adjuster’s license for appropriate state(s)
• Processing FNOL 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
• Knowledge of Claim processing policy and procedures
• Knowledge of General claim processing functions
• Knowledge of Claim processing systems
• Knowledge of Telephone etiquette
• Ability to provide a high level of customer service in a professional call center environment
• 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
• 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
• Successfully complete at least one of the following within 9 months of hire: AAA general claim policy training, Policy, negligence and no-fault training
• Work independently
• 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
• Willingness and ability to work irregular shifts, including weekends and holidays

Nice To Haves

• Associate’s degree in Business Administration or a related field, or the equivalent in related work experience
• Completion of (IIA) Insurance Institute of America or other insurance coursework
• Experience in a claim related field such as insurance, automotive, medical or legal services
• Experience in a call center environment
• Experience Utilizing ACG automated systems
• Experience Investigating and resolving claims related problems
• Experience Handling claims or claims support tasks such as processing glass claims, car rentals, invoice payments, etc.
• Knowledge of ACG insurance processes and procedures
• Knowledge of auto and home repair basics and cost estimating
• Knowledge of State insurance laws
• Knowledge of Regulatory compliance requirements
• Knowledge of Property and casualty insurance policy language and provisions
• Knowledge of Claims quality service standards
• Knowledge of Liability, negligence, No-Fault principles and subrogation

Responsibilities

• Taking first notice of loss
• Handling claim inquiries
• Initiating claim services
• Handling low-complexity, one-touch claims in a call center environment
• Identifying non-complex claims for one-touch claim adjudication upon intake
• Determining the type and extent of loss and ensuring the claim is consistent with all reported facts
• Reviewing necessary legal and police/fire reports to process claims
• Interpreting policy language and applying coverage to authorize or deny claims
• Initiating services, authorizing, and resolving issues related to services such as car rental and vehicle repairs and non-complex homeowner claims
• Initiating and creating payments, settling or recommending settlement value of claims within specified limits
• Identifying additional claim exposures and creating sub-claims as necessary
• Referring files for investigation as warranted
• Informing insured of coverage decision on claims within defined scope
• Responding to claimant inquiries and explaining payments
• Reviewing the status of open and closed reserves and adjusting consistent with exposures
• Identifying claims for salvage and subrogation potential in accordance to company policy
• Ensuring compliance with state regulations
• Completing first notice of loss for all policy products
• Handling inbound claim inquiries received via phone, the ACG website and other sources
• Explaining the benefits of company programs to customers
• Initiating services, such as arranging for repair inspections, vehicle tows and car rental
• Providing basic information to members regarding claims procedures in accordance with Customer Interaction Model
• Promoting customer satisfaction and providing seamless service to ensure customer service goals and standards are met
• Navigating through various sources of information and claim processing systems
• Responding to members/customers questions in a timely manner

Benefits

• Medical, dental and vision benefits
• 401k Match
• Paid parental leave and adoption assistance
• Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
• Paid volunteer day annually
• Tuition assistance program, professional certification reimbursement program and other professional development opportunities
• AAA Membership Discounts, perks, and rewards

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED