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Job Type:
Full time
Exempt/Non Exempt:
Salary
Job Description:
MedPay Adjuster - The Auto Club Group
What you will do:The Auto Club Group is seeking prospectiveClaim Representative II 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.
In this position, you will have the opportunity to:
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, and initiating 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.
With our powerful brand and the mentoring, we offer, you will find your position as aClaim Representative II can lead to a rewarding career at our growing organization.
Work EnvironmentThis 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 you will benefit:Claim Representative II will earn a competitive salary of $57,600 to $70,000 annually 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:Required Qualifications (these are the minimum requirements to qualify)Education (include minimum education and any licensing/certifications):
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:One year of experience with:
Negotiating claim settlements
Securing and evaluating evidence
Preparing manual and electronic estimates
Subrogation claims, including identifying recovery opportunities
Resolving coverage questions
Taking statements
Establishing clear evaluation and resolution plans for claims
Knowledge of:
Essential Insurance Act (Michigan)
Fair Trade Practices Act as it relates to claims
Subrogation procedures and processes
Intercompany arbitration/dispute resolution
Knowledge of:
Negligence Law
Medical terminology and human anatomy
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 workload and responsibilities
Research analyze and interpret subrogation laws in various states
Strong negotiating skills
Preferred QualificationsKnowledge of:
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
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Who We Are
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The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and... For full info follow application link.
As an equal opportunity employer, ACG is committed to providing equal opportunity in all employment practices,
including but not limited to: selection, hiring, assignment, re-assignment, promotion, transfer, compensation,
evaluation, benefits, training and development, discipline and termination. The company prohibits discrimination,
harassment, and retaliation in employment based on race, color, religion, national origin, gender, sexual
preference/orientation, marital status, pregnancy, childbirth or related medical conditions, age, disability or
handicap, citizenship status, service member status, genetic information, or any other category protected by
federal, state, or local law. Violation of this policy may result in disciplinary action including termination of
employment.
