Michigan Claim Customer Service Representative

AAA-The Auto Club Group•Detroit, MI

2d•$19 - $22•Hybrid

About The Position

As a Michigan Claim Customer Service Representative, you will serve as the first point of contact for members reporting losses, guiding them through the claims process with professionalism, empathy, and efficiency. In this fast-paced call center environment, you will handle claim inquiries, initiate claim services, and resolve low-complexity, one-touch claims by interpreting coverage, authorizing services, processing payments, and ensuring compliance with company policies and state regulations. This role combines strong customer service, critical thinking, and claims handling expertise to deliver seamless support and timely claim resolution while promoting a positive member experience. Attendance is mandatory during the initial 90-day training and probationary period for this position. New hires are expected to be present for all scheduled training sessions. Absences, tardiness, or early departures during this period may impact continued employment. Candidates should ensure they are able to meet these attendance expectations before applying for consideration.

Requirements

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, General claim processing functions, Claim processing systems, Telephone etiquette
Ability to: Provide a high level of customer service in a professional call center environment using the following skills: 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 (e.g. MI liability basics regarding uninsured motorists)
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
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
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.
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 claims support tasks such as processing glass claims, car rentals, invoice payments, etc.
Knowledge of: 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

Responsibilities

Responsible for taking first notice of loss
Handling claims inquiries
Identifies non-complex claims for one-touch claim adjudication upon intake
Determines the type and extent of loss and ensures the claim is consistent with all reported facts
Reviews necessary legal and police/fire reports to process claims as necessary
Interprets policy language and applies coverage to authorize or deny claims
Initiates services, authorizes, and resolves issues related to services such as car rental and vehicle repairs and non-complex homeowner claims (e.g. food spoilage)
Initiates and creates payments
Settles or recommends settlement value of claims within specified limits
Identifies additional claim exposures and creates sub-claims as necessary
Refers files for investigation as warranted
Informs insured of coverage decision on claims within defined scope
Responds to claimant inquiries and explains payments
Documents claim files
Reviews the status of open and closed reserves and makes adjustments consistent with exposures
Identifies claims for salvage and subrogation potential in accordance with company policy
Closes claims in a timely manner
Ensures compliance with state regulations
Completes first notice of loss (FNOL) for all policy products and handles inbound claim inquiries received via phone, the ACG website and other sources
Provides basic information to members regarding claims procedures in accordance with Customer Interaction Model
Promotes customer satisfaction and provides seamless service to ensure customer service goals and standards are met
Navigates through various sources of information and claim processing systems (E.g., FACTS, CPS, Point of Sale, IPM insurance systems, Intranet/Internet, manuals and call center models)

Benefits

PTO, paid sick leave
Medical plans with multiple coverage options, including HSA eligibility.
Prescription drug coverage.
Dental and vision benefits.
Employee Assistance Program (confidential support services).
Company-paid basic life insurance.
Optional supplemental life insurance and dependent coverage.
Short-term and long-term disability coverage.
Critical illness, accident, and pet insurance options.
401(k) plan to support long-term financial goals. 3% automatic deferral upon eligibility; may contribute 1% to 50% of eligible earnings, either pre or post tax. Company match of 50% paid on employee contributions up to 6% of pay, payable to employees following the end of the year; immediate vesting. Additional company contribution of 4% of pay each pay day into your account; 100% vested after three (3) years of service.
Health Savings Account (HSA) and Flexible Spending Accounts (FSA) options.
Paid Time Off (PTO): Accrual-based, increases with tenure, eligible at 90 days of employment. Full-time new employees will receive up to 12 PTO days annually; accrual based on start date and may include additional PTO based on role and/or state & local requirements. Part-time employee PTO hours are calculated based upon the standard weekly hours the employee is scheduled to work and will accrue at a minimum of 3 hours per month.
Paid Holidays: Full-time employees are eligible for 10 company-paid holidays annually, in addition to 1 mental health day, 2 floating holidays and 1 volunteer day. Holidays vary by business unit schedules. Part-time employees are eligible for 8 company-paid holidays annually, in addition to 1 mental health day and 2 floating holidays. Holidays vary by business unit schedules.
Paid leave programs, including parental, bereavement, jury duty, and military leave.
Tuition assistance (up to $5,250 annually; 80% covered by ACG).
Professional certification support with 100% reimbursement for eligible programs.
Opportunities for career development and advancement.
Complimentary AAA membership with roadside assistance and travel discounts.
Adoption assistance program.