Fremont Michigan Property Desk Claim Representative II

Auto Club Group•Fremont, MI

3d•Remote

About The Position

This role involves handling moderately complex claims within Claim Handling Standards, resolving coverage questions, taking statements, and establishing clear evaluation and resolution plans. The representative will review assigned claims, contact insureds and other parties, set expectations, and initiate documentation. A key part of the role is completing coverage analysis, investigating claim facts, reviewing damages, evaluating the financial value of the loss, and approving payments. The position also involves referring claims to other company units when necessary and thoroughly documenting claim files. Employees in 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 the field role. The role requires investigating claims that need coverage analysis and preparing damage estimates using claims software when handling claims in the field. The representative will also review estimates for accuracy and may monitor contractor repair status.

Requirements

Reside within the state of Michigan for consideration.
Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience in property adjusting.
Eligible to acquire a State Adjuster’s license within 90 days of hire and maintain as specified for appropriate states (in states where an Adjuster’s license is required).
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.
Ability to analyze and solve problems while demonstrating sound decision making skills.
Ability to prioritize claim related functions.
Ability to process time sensitive data and information from multiple sources.
Ability to manage time, organize and plan workload and responsibilities.
Ability to research, analyze, and interpret subrogation laws in various states.
Strong negotiating skills.
Ability to work outside normal business hours as needed.
Regular and reliable attendance is essential.
Consent to a background and drug screen based on the requirements of the position.

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.
Full claims cycle experience preferred.

Responsibilities

Handle moderately complex claims within Claim Handling Standards.
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.
Initiate documentation in the claim handling system.
Complete coverage analysis, including a review of policy coverages and provisions, and their 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.
Investigate the facts regarding the claim to 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.
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.
Prepare damage estimates using claims software (when handling claims in the field).
Review estimates for accuracy.
Monitor contractor repair status and update (may be required).