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):
Performs a variety of technical claim support functions to include preliminary inspections, expense tracking, pc/lan administration, authorizing additional reserves, etc. Reviews moderately complex claim files. Evaluates, negotiates, responds to inquiries and settles claims within specified limits. Maintains contact with individuals or organizations such as doctors, employers, cost containment vendors, etc. Determines the type and extent of loss and ensures the claim is consistent with all reported facts. Reviews necessary legal and police/fire reports to process claims as necessary. . Documents claim files. Refers files for investigation as warranted. Regularly makes payments, settles or recommends settlement value of claims according to policy coverage. Reviews the status of open and closed reserves and makes adjustments consistent with exposures. Reviews assigned claim files on diary for progress toward completion of settlements. Authorizes checks as required. Explains payments to claimants and responds to claimant' inquiries. Reviews files for salvage potential and handles salvage in accordance to company policy. Closes claim files in a timely manner.
Supports professional staff members and management in a variety of activities such as telephone/computer problem resolution, handling subrogation and salvage operations, etc. Completes subrogation forms, collects necessary documentation and forwards files to the recovery unit for collection. Assumes responsibility for files that were previously assigned to other claim staff members as necessary. Assists claims management in the assignment and distribution of new claims. Coordinates or conducts special claim surveys and projects. May monitor the maintenance, repair, remodeling or renovation of assigned facility. Requests and authorizes payment of all incoming bills. Serves as contact person and coordinator for corporate real estate. Assists in orienting and training employees as assigned. Assists administrative support staff in resolving claim coverage problems as necessary. Develops, maintains and/or modifies written manuals and materials for acg insurance products and processes, including branch, centralized and home office claims, underwriting and actuarial. May coordinate the production and distribution of materials to insurance and branch employees. Compiles area production statistical reports as requested. May visit and assess storage requirements for branch locations. Monitors file destruction and shifting of files to accommodate incoming files at office or warehouse location. Packs and transports files to warehouse. Completes branch destruction as needed. May assist in the review of excess tolerance reports and work products to ensure accuracy of checks issued.
Performs general claims processing functions as necessary.
Preferred Qualifications:
Associate’s degree in business administration or a related field, or the equivalent in related work experience.
Knowledge-of and experience with the following:
-Michigan civil litigation procedures and processes.
-Michigan court rules.
-Litigation reporting, analysis, and data tracking.
-Insurance defense practices and procedures.
Abilities to:
-Create and complete diverse reports within time-bound guidelines.
-Work autonomously on multiple projects.
-Adjust quickly to changing priorities.
-Review and analyze data, and make recommendations based on analysis.
Work Environment
Works indoors in a temperature controlled office environment.
Required Qualifications (these are the minimum requirements to qualify):
Candidates must be eligible to acquire and maintain a state adjuster’s license for appropriate state(s).
Successful completion of at least one of the following, or the ability to complete within 9 months of hire:
AAA general claim policy training
Homeowner training
Policy, negligence, and no-fault training
Injury claim training class for technical support staff or equivalent
Experience to include:
As a general member service representative or equivalent.
Investigating and resolving claims or insurance problems
Utilizing pcs and software packages (i.e. word, power point, visio, abc flowcharter)
Knowledge of:
May need knowledge in a specialized area such as:
Medical billing practices
Processing subrogation and judgment files
Claims quality service standards
Moderate knowledge of additional living expense adjustment
Moderate knowledge of Michigan no fault law
Claim processing policies and procedures
Moderate knowledge of medical terminology and human anatomy
Essential insurance act
General injury/liability claims
Demonstrated skill in:
Organization and planning
Analyzing and problem solving
Decision making
Written communication to include record keeping and report preparation
**Ability to include:
Communicate effectively over the telephone
Analyze and resolve problems
Accurately enter information on a terminal keyboard
Make determinations on extent of loss, exposures, proof necessary to support payment of non-complex injury claims
Access a mainframe computer
Effectively respond to questions and concerns
Communicate effectively with customers and/or medical staff
Prepare and present activity and statistical reports
Work under pressure
Use automated processing and computer systems
Record and maintain data accurately and in a timely fashion
Enter basic format specifications for forms, manuals, procedures, etc. Into the computer system
Summarize/format statistical information, memos, tables, etc.
Investigate, evaluate and settle claims within specified limits
Service, investigate, price, evaluate and settle minor injury claims
Work effectively in a team environment
Organize and plan work within established time frames
Excellent verbal communication skills required in understanding members' concerns and to provide high quality customer service.
Willingness to work irregular hours to respond to emergencies and provide service to customers
W illingness to relocate.
P ossession of a valid state driver's license.
The Auto Club Group offers a competitive compensation and benefits packages including a base salary with performance based incentives; medical/dental/vision insurance, pension, 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