Fremont Michigan Property Desk Claims Specialist

Auto Club Group•Fremont, MI

15h•Remote

About The Position

This role involves handling complex technical issues and claims under minimal supervision with high-level approval authority. Responsibilities include reviewing assigned claims, contacting insureds and affected parties, setting expectations, documenting the claim handling system, performing complex coverage analysis, identifying policyholder benefits, creating sub-claims, investigating claim facts to determine payment, applicable limits, exclusions, and recovery potential. The specialist will review damages, determine the applicability of state law, evaluate loss value, approve payments, and refer claims to other units as necessary. Thorough documentation and coding of claim files, along with closure activities in the claims management system, are essential. Strong negotiating skills are required. Claim Specialists in the Homeowner/CAT claim unit handle claims valued over $25,000 (inside desk role) and over $100,000 (field role). Field roles require preparing damage estimates using claims software, reviewing estimates for accuracy, and potentially monitoring contractor repair status. The role may also involve assisting the Claim Manager with file reviews and training.

Requirements

Reside within the state of Michigan.
Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience.
Eligible to acquire a State Adjuster’s license within 90 days of hire and maintain as specified for appropriate states (if required).
Valid driver's license (if primary responsibilities involve in-person inspections or meetings).
Three years of experience or equivalent training in negotiation of claim settlements, securing and evaluating evidence, preparing manual and electronic estimates, subrogation claims, resolving coverage questions, taking statements, and establishing clear evaluation and resolution plans for claims.
Advanced knowledge of Essential Insurance Act (Michigan), Fair Trade Practices Act as it relates to claims, subrogation procedures and processes, intercompany arbitration, handling simple litigation, and advanced 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 safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc.
Ability to research, analyze and interpret subrogation laws in various states.
Ability to travel outside of assigned territory which may involve overnight stay.
Ability to relocate, work evenings or weekends.

Nice To Haves

Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience.
Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent CPCU coursework or designation.
Xactware Training.

Responsibilities

Review assigned claims, contact the insured and other affected parties, and set expectations for the remainder of the claim process.
Initiate documentation in the claim handling system.
Complete complex coverage analysis and ensure all possible policyholder benefits are identified.
Create additional sub-claims if needed.
Conduct an investigation of 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 and 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 valued over $25,000 (for the inside desk role) and over $100,000 (for field role).
Investigate claims requiring in-depth coverage analysis.
Prepare damage estimates using claims software when handling claims in the field.
Review estimates for accuracy.
Monitor contractor repair status.
Assist Claim Manager with file reviews and training.