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Claim Specialist

Company: AAA Auto Club
Location: Aurora
Posted on: November 20, 2018

Job Description:

The Auto Club Group (ACG) provides membership, travel, insurance and financial services offerings to approximately 9 million members and customers across 11 states and 2 U.S. territories through the AAA, Meemic and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. Primary Duties and Responsibilities (details of the basic job functions): Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed. 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. Claim Specialists assigned to Homeowner/CAT claim unit 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. When handling claims in the field, must prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status. May assist Claim Manager with file reviews and training. Preferred Qualifications: Education: * 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 Ability to * lift up to 25 pounds * climb ladders * walk on roofs Work Environment: Depending on line travel may be required to various repair facilities in order to conduct inspections/re-inspections, visit patients, hospitals, attorneys, rehabilitation centers, repair facilities, etc. per with exposure to road hazards and temperature extremes. For Homeowners and CAT may require deployment to territories impacted by storms. Required Qualifications (these are the minimum requirements to qualify): Education (include minimum education and any licensing/certifications): Post for All Claim Units: * Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience * 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. * Must have a valid State Driver's License Experience: Post for All Claim Units: * Three years of experience or equivalent training in the following: * negotiation of 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 Knowledge and Skills: 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 * advanced knowledge of building construction and repair techniques Ability to: * 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 work load and responsibilities * safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. * research analyze and interpret subrogation laws in various states * travel outside of assigned territory which may involve overnight stay * relocate, work evenings or weekends The Auto Club Group offers a competitive compensation and benefits package including a base salary with performance based incentives; medical/dental/vision insurance, 401(k), generous time off, a complimentary AAA Membership and much more! Important Note: The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all of its affiliated companies, is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.SDL2017

Keywords: AAA Auto Club, Elgin , Claim Specialist, Other , Aurora, Illinois

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