Michigan Homeowners Claim Representative II

Auto Club Group • Auburn Hills, MI

2d • $64,000 - $72,000 • Remote

About The Position

Michigan Homeowners Claim Representative II - AAA The Auto Club Group Reports to: Claim Manager I What you will do : Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units, resolve coverage questions, take statements, and establish clear evaluation and resolution plans for claims. Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim, and 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. Employees assigned to the Homeowner/CAT claim unit will handle claims generally valued between $5,000 and $25,000 (for the inside desk role) and up to $100,000 (for field role). Investigate claims requiring coverage analysis. When handling claims in the field, prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status and update.

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 the following:
• Negotiating 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
• Advance knowledge of:
• Essential Insurance Act (Michigan)
• Fair Trade Practices Act as it relates to claims
• Subrogation procedures and processes
• Intercompany arbitration
• Knowledge of building construction and repair techniques
• 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 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

• Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
• Xactimate software experience/training or experience in an equivalent software
• Claims adjuster experience specifically in home/property claims preferred
• Experience working within a customer service setting
• Call center experience or experience handling high volume calls preferred, but not required
• Excellent communication skills both oral and written
• Experience working within an insurance or claims-based role for one year or more
• Full claims cycle experience preferred

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, set expectations for the remainder of the claim, and 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
• Investigate claims requiring coverage analysis
• Prepare damage estimates using claims software
• Review estimates for accuracy
• Monitor contractor repair status and update

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 and much more

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 101-250 employees