Claim Customer Service Representative (michigan) - Remote Eligible

Claim Customer Service Representative (Michigan) – The Auto Club Group

AAA The Auto Club Group is seeking a Claim Customer Service Representative who will be responsible for taking first notice of loss, handling claim inquiries, initiating claim services, and handling low-complexity, one-touch claims in a call center environment.

In this position, you will have the opportunity to:

• Identify non-complex claims for one-touch claim adjudication upon intake.
• Determine the type and extent of loss and ensure the claim is consistent with all reported facts.
• Review necessary legal and police/fire reports to process claims as necessary.
• Interpret policy language and apply coverage to authorize or deny claims.
• Initiate services, authorize, and resolve issues related to services such as car rental and vehicle repairs and non-complex homeowner claims (e.g. food spoilage).
• Initiate and create payments, settle or recommend settlement value of claims within specified limits.
• Identify additional claim exposures and create sub-claims as necessary.
• Refer files for investigation as warranted. Inform insured of coverage decision on claims within defined scope.
• Respond to claimant inquiries and explain payments.
• Review the status of open and closed reserves and adjust consistent with exposures. Identify claims for salvage and subrogation potential in accordance to company policy.
• Ensure compliance with state regulations.
• Complete first notice of loss for all policy products and handle inbound claim inquiries received via phone, the ACG website and other sources.
• Explain the benefits of company programs to customers, and initiate services, such as arranging for repair inspections, vehicle tows and car rental.
• Provide basic information to members regarding claims procedures in accordance with Customer Interaction Model.
• Promote customer satisfaction and provide seamless service to ensure customer service goals and standards are met.
• Navigate through various sources of information and claim processing systems (E.g., FACTS, CPS, Point of Sale, IPM insurance systems, Intranet/Internet, manuals and call center models). Respond to members/customers questions in a timely manner.

Work Environment

This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.

How will you benefit

Claim Customer Service Representative will earn a competitive salary of $18.74 to $20.82 per hour with annual bonus potential based on performance. Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include:

• 401k Match
• Medical
• Dental
• Vision
• PTO
• Paid Holidays
• Tuition Reimbursement

We're looking for candidates who:

Education (include minimum education and any licensing/certifications):

• High School Diploma or equivalent
• Completion of AAA approved call center training program, appropriate level ACG Claim Representative Training program and ongoing training and certification for the position
• Must be eligible to acquire and maintain a state adjuster's license for appropriate state(s).

Experience:

• Processing FNOL information and handling claim inquiries utilizing PCs and software packages (e.g. ACG claim systems, Microsoft Word, Excel)
• Reading and comprehending various Customer Care service tools (manuals, work models, etc.)
• Performing mathematical calculations including adding, subtracting, percentages, etc.
• Analyzing and resolving problems

Knowledge of:

• Claim processing policy and procedures
• General claim processing functions
• Claim processing systems
• Telephone etiquette

Ability to provide a high level of customer service in a professional call center environment using the following skills:

• Strong interpersonal skills demonstrated through work experience, participation in extra-curricular activities and/or community involvement
• Strong communication skills required in understanding customers' concerns and to provide high quality customer service as demonstrated through the effective use of the customer care call center model
• Effective listening skills

Ability to learn and apply claim handling skills, including:

• Policy analysis and coverage application
• Claim payment coding, issuance, and exception handling
• Proactive customer contact and issue resolution
• Car rental coverage knowledge
• Claims' related policies and procedures
• Auto and home repair estimate basics and compliance review
• State compliance requirements
• Subrogation identification and referral (e.g. MI liability basics regarding uninsured motorists)
• Understand insurance fraud scenarios and recognize potential fraud indicators
• Issue written correspondence
• Prioritize claims-related functions
• Successfully complete at least one of the following within 9 months of hire:
• AAA general claim policy training.
• Policy, negligence and no-fault training
• Work independently
• Work under pressure
• Record and maintain information accurately and in a timely fashion
• Work effectively in a team environment
• Sit for the majority of the workday
• Willingness and ability to work irregular shifts, including weekends and holidays.

Preferred Qualifications:

Education:

• Associate's degree in Business Administration or a related field, or the equivalent in related work experience.
• Completion of (IIA) Insurance Institute of America or other insurance coursework.

Experience to include:

• A claim related field such as insurance, automotive, medical or legal services
• A call center environment
• Utilizing ACG automated systems
• Investigating and resolving claims related problems
• Handling claims or claim support tasks such as processing glass claims, car rentals, invoice payments, etc.

Knowledge of:

• ACG insurance processes and procedures
• Auto and home repair basics and cost estimating
• State insurance laws
• Regulatory compliance requirements
• Property and casualty insurance policy language and provisions
• Claims quality service standards
• Liability, negligence, No-Fault principles and subrogation