Michigan Homeowners Claim Representative II

AAA-The Auto Club Group • Auburn Hills, SC

4d • Remote

About The Position

This role involves handling moderately complex homeowners claims within Claim Handling Standards, either in the field or inside units. The representative will resolve coverage questions, take statements, establish evaluation and resolution plans, and conduct investigations to determine claim validity, applicable limits, exclusions, and recovery potential. Responsibilities include reviewing policy coverages, identifying policyholder benefits, completing damage reviews, evaluating financial loss, approving payments, and referring claims to other departments when necessary. Thorough documentation in the claims management system and utilization of strong negotiating skills are essential. For the inside desk role, claims are generally valued between $5,000 and $25,000, while the field role handles claims up to $100,000. The role also involves preparing damage estimates using claims software for field claims, reviewing estimates for accuracy, and monitoring contractor repair status.

Requirements

• Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience in property adjusting.
• 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.
• One year of experience or equivalent training in negotiating claim settlements.
• One year of experience or equivalent training in securing and evaluating evidence.
• One year of experience or equivalent training in preparing manual and electronic estimates.
• One year of experience or equivalent training in subrogation claims.
• One year of experience or equivalent training in resolving coverage questions.
• One year of experience or equivalent training in taking statements.
• One year of experience or equivalent training in establishing clear evaluation and resolution plans for claims.
• Advance knowledge of Essential Insurance Act (Michigan).
• Advance knowledge of Fair Trade Practices Act as it relates to claims.
• Advance knowledge of Subrogation procedures and processes.
• Advance knowledge of Intercompany arbitration.
• Knowledge of building construction and repair techniques.
• Ability to handle claims to the line Claim Handling Standards.
• Ability to follow and apply ACG Claim policies, procedures and guidelines.
• Ability to work within assigned ACG Claim systems including basic PC software.
• Ability to 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.
• Research, analyze, and interpret subrogation laws in various states.
• Strong negotiating skills.
• Ability to work outside normal business hours as needed.

Nice To Haves

• 1+ years of Xactimate software experience preferred.
• Full cycle homeowners/property claims adjusting experience preferred, but not required.
• Strong customer service and customer resolution skills highly preferred.
• Experience as a desk or virtual adjuster strongly preferred.
• High volume queue calling or call center experience a plus.
• High volume full cycle claims handling experience preferred, but not required.
• Member focused mindset candidates highly preferred.
• Excellent communication skills both oral and written.

Responsibilities

• Handle moderately complex claims within Claim Handling Standards in the field or inside units.
• Resolve coverage questions.
• Take statements.
• Establish clear evaluation and resolution plans for claims.
• Review assigned claims, contact the insured and other affected parties, and set expectations for the remainder of the claim.
• Initiate documentation in the claim handling system.
• Complete coverage analysis including a review of policy coverages and provisions, and the applicability to the reported loss.
• Ensure all possible policyholder benefits are identified, create additional sub-claims if needed or refer complex claims to management or the appropriate claim handler.
• 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.
• Prepare damage estimates using claims software when handling claims in the field.
• Review estimates for accuracy.
• Monitor contractor repair status and update.

Benefits

• A competitive annual salary between $64,000 - $72,000
• 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 and much more

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed